On October 2010, the Canadian Cardiovascular Society (CCS) issued guidelines specific to the use of antiplatelet therapy, including their use in multiple settings, such as primary and secondary prevention, as well as following PCI and CABG surgery and in patients with peripheral arterial disease and diabetes. In the US and Europe, guidelines for antiplatelet therapy follow a more disease-based approach. Join Drs Bob Harrington, Alan Bell, Keith Fox, and Jean-François Tanguay as they discuss the regional differences in the development of guidelines, the reassuring similarities, and the importance of implementation and outcomes measurement.

Front-page allegations of inappropriate stenting in the US have fueled a storm that has challenged the integrity of various high-profile physicians, shaken the patient-physician bond, and prompted some to doubt the widespread practice of stenting. How do European interventional cardiologists interpret this debate? Our panel of experts met during the EuroPCR meeting in Paris to share their thoughts on this controversy. While pondering whether inappropriate stenting also occurs in Europe, they examine the role of appropriate-use guidelines, discuss how to effectively oversee PCI in Europe, and debate whether structured auditing or informal peer review is best to ensure optimal patient care.

The ever-evolving field of electronic medical records can be confusing and the thought of selecting an EMR system daunting. What is right for your practice? How much will it really cost? How do you make the transition? What about privacy issues? Drs Seth Bilazarian, Jay Alexander, Vincent Bufalino, and Ronald Karlsberg share their experiences as early adopters of EMR and offer advice on how to manage the challenges and steer clear of the pitfalls on the path to using EMR to improve quality of care.

What ails the younger woman's heart? What are the obstacles to appropriate treatment for younger women with heart disease? Drs Walton-Shirley, Cook, and Suri took time out from a recent conference cosponsored by the Mayo Clinic, National Heart, Lung, and Blood Institute (NHLBI), and WomenHeart to address heart disease in the younger woman and chart a path to better care.

A small trial testing the appropriate duration of dual antiplatelet therapy suggests that some patients can stop clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis) after just six months following drug-eluting-stent implantation. Although the study was not powered for hard clinical end points, such as death, MI, or stent thrombosis, investigators report that one-year rates of target vessel failure (TVF) were equivalent among patients treated with six and 12 months of dual antiplatelet therapy. Interventionalists Drs David Kandzari, Laura Mauri, and Bob Harrington talk about what the trial results mean for clinical practice and what they hope to learn about dual antiplatelet therapy from future trials.

Dr David Antoniucci (Careggi Hospital, Florence, Italy) discusses high residual platelet reactivity after clopidogrel loading and long-term thrombotic events in patients with acute coronary syndrome undergoing invasive treatment. Filmed in Paris during EuroPCR 2011 on May 18.

Dr Neils Ramsing Holm (Aarhus University Hospital, Denmark) discusses the randomized comparison of manual compression and use of a femoral vascular closure device after femoral-artery-access coronary angiography. Filmed in Paris during EuroPCR 2011 on May 18.

Dr Runlin Gao (Fu Wai Hospital, Beijing, China) discusses the prospective randomized trial of the NOYA sirolimus-eluting stent with a biodegradable coating compared with the Firebird 2 sirolimus-eluting stent with a durable coating in patients with coronary artery disease: Nine-month angiographic and 12-month clinical results. Filmed in Paris during EuroPCR 2011 on May 18.

Dr Didier Carrié (CHU Rangueil, Toulouse) discusses the first randomized trial comparing the reservoir-based polymer-free CRE8 drug-eluting stent with the Taxus Liberté. Filmed in Paris during EuroPCR 2011 on May 18.

Dr SH Hofma (Medisch Centrum Leeuwarden, the Netherlands) discusses the randomized multicenter trial comparing first-generation sirolimus-eluting with second-generation everolimus-eluting stents in acute MI. Filmed in Paris during EuroPCR 2011 on May 18.

High-profile cases of inappropriate stenting have shocked all and stirred passions among patients and the public, media, medical professionals, and legislators, causing the integrity of interventional cardiology at large to come under fire. How widespread is the inappropriate use of percutaneous coronary intervention? What constitutes appropriate care? Have the 2009 Appropriateness Criteria been widely adopted by cardiologists? Is there a way to "police" uptake of the guidelines? Our panel of experts gathered during the recent American College of Cardiology 2011 Scientific Sessions to discuss what constitutes appropriateness, how it's measured, and how it should be enforced. They debate what interventional cardiology is doing to standardize appropriate care, what measures should be adopted to ensure that outliers are reined in, and, in an era of prolonged economic woes, ask how costs can be contained while delivering the best, most appropriate patient care.

Why is heart disease in women sometimes overlooked? What explains outcome disparities and the undertreatment of women with heart disease? Drs Walton-Shirley, Hayes, and Desvigne-Nickens gathered at "In the Prime of Her Life," a conference cosponsored by the Mayo Clinic, National Heart, Lung, and Blood Institute (NHLBI), and WomenHeart, to answer these questions and suggest solutions.

From PARTNER to EVEREST II, technology-oriented clinical trials are presenting new treatment options and new challenges. Dr Bob Harrington sits down with Drs Laura Mauri and Neil Moat to talk about the importance of the heart team in the success of these trials and how to ensure this multidisciplinary approach in applying trial results in clinical practice.

Dr Robert Califf conducts a series of in-depth and personal interviews with his peers in the world of cardiology to find out what makes them tick, how they feel about the future, and what lessons they have learned during their exceptional careers. A longstanding leader in the hypertension world, Dr Suzanne Oparil has, during the course of her brilliant career, moved from the family dairy farm in Elvira, NY, to Columbia, Harvard, the University of Chicago, and the University of Alabama at Birmingham. Learn more about Dr Oparil's exceptional life, her groundbreaking research, the renowned hypertension programs that she set up, and what has driven her to always "get to the next level."

Seven of the world's top cardiologists gathered together in New Orleans to tackle the issues raised by the major trials presented at the American College of Cardiology (ACC) 2011 Scientific Sessions. Dr Valentin Fuster sits down with Drs Robert Harrington, David Kandzari, Harlan Krumholz, Laura Mauri, Neil Moat, and Clyde Yancy to talk about the need for caution in applying the PARTNER cohort A results, the challenges of treating mitral regurgitation, and whether or not STICH will change clinical practice.

Join Dr Bob Harrington and fellows Dr Mark Huffman and Dr Jerry Bloomfield for a wide-ranging discussion on global chronic disease from diabetes and central obesity in India to the cardiovascular implications of HIV and HIV treatment in sub-Saharan Africa. For those inspired to follow in their footsteps, the panel reviews various training opportunities and the many advantages of working in global health.

The statistics for obesity in the US continue to alarm, with the Centers for Disease Control and Prevention reporting 33 states with an obesity rate of over 25% and estimating that over 72 million Americans are obese. Is there a way to stop the obesity juggernaut? Drs Roger Blumenthal, Bob Eckel, and Christopher Gardner gathered to discuss their thoughts on obesity and offer practical tips for cardiologists and healthcare professionals to address options for permanent weight loss in their patients.

Despite a developed understanding of the pathophysiology of cardiovascular disease and the existence of evidence-based therapies, disparities in patient outcomes persist. In this roundtable exchange, Drs Clyde Yancy, Elizabeth Ofili, and Vivian Rambihar ponder the research in disparities among South Asian populations and populations of African origin and discuss how disparity varies from difference, the role of nonphysiological factors, physician bias, and practical suggestions to solve the problem.

Join heartwire's Shelley Wood for an in-depth discussion with Drs Sunil Rao and Renu Virmani on the safety of drug-eluting stents, their hopes for the future of transcatheter aortic valves, and why Dr Virmani was not surprised by the results of CLOSURE I.

In the GRAVITAS trial, 5429 patients on the regular clopidogrel dose underwent platelet-function tests with the VerifyNow assay (Accumetrics, San Diego, CA) 12 to 24 hours after PCI. Of these, 2214 (41%) had high residual platelet reactivity (platelet reactivity units [PRU] >230) and were randomized to continue on the 75-mg regular clopidogrel dose or to receive another 600-mg loading dose and a higher maintenance dose of 150 mg daily. Baseline characteristics showed that most patients were at relatively low risk, with 80% having stable coronary artery disease. At six months of follow-up, the composite end point of cardiovascular death/MI/stent thrombosis was identical in both groups, at 2.3%. heartwire's Sue Hughes sits down with Dr Sunil Rao to talk about the clinical implications of these results and what they mean for the future of platelet-function testing.