Author + information
- Ralph Brindis, MD, MPH, FACC, ACC President⁎ ( and )
- Clyde Yancy, MD, FACC, FAHA, AHA President
- ↵⁎Address correspondence to:
Ralph Brindis, MD, MPH, FACC, American College of Cardiology, 2400 N Street NW, Washington, DC 20037
At this time of transition in leadership for both the American College of Cardiology (ACC) and the American Heart Association (AHA), we felt it appropriate to address the current and future working relationship between these 2 respected organizations.
The ACC and its Foundation (ACCF), as leading professional organizations, and the AHA, as a leading science-based voluntary health organization, are among the most prominent cardiovascular-focused entities in the U.S. and represent the voice and energy of broad constituencies of the cardiovascular community. The mission of the ACC is to “advocate for quality cardiovascular care—through education, research promotion, development, and application of standards and guidelines—and to influence health care policy.” The mission of the AHA is “building healthier lives, free of cardiovascular diseases and stroke.” The confluence of these missions creates a synergy of purpose that has been responsible for marked practice improvements and significant reductions in deaths due to heart disease and stroke.
The AHA was founded in 1924 by a pioneering group of physicians concerned about the dearth of substantive information to inform the treatment of those with heart disease. The ACC was founded in 1949 to address the unmet educational needs of practicing cardiovascular specialists. Over time, it became apparent that certain synergies were at play between the 2 aspiring organizations, and increasingly many leaders and practitioners of cardiology joined both organizations.
Today, both organizations continue to undergo transformative changes reflecting the shared and unique needs of the 2 organizations, their different constituencies and—most importantly—the needs of cardiovascular patients and those at risk for heart disease and stroke. The ACC and the AHA have often harnessed the collective skill set of both organizations to accomplish the greater good of improving cardiovascular health, advancing the benefits of cardiovascular science, and providing the best care for patients with cardiovascular diseases. We have also advocated for meaningful innovations and, where needed, changes in our own organizations to facilitate and accomplish these lofty goals. These synergies have wisely leveraged volunteer, staff, and financial resources in arenas involving science, quality, research, professional and patient education, consumer health information, and advocacy.
How We Are Synergistic
Our most successful mutual endeavors have been in the area of translating science and improving quality. The creation of the ACCF/AHA Taskforce on Practice Guidelines is an obvious and well-known success. First crafted in 1984, there are now 18 cardiovascular clinical practice guidelines that are continually updated and are viewed nationally as the definitive repositories of evidence-based cardiovascular medicine for practice. Both organizations have further leveraged staff resources and funding to create the ACCF/AHA Task Force on Clinical Data Standards, the ACCF/AHA Task Force for Expert Consensus Documents, the ACCF/AHA Task Force for Performance Measures, and the ACCF/AHA/American College of Physicians–American Society of Internal Medicine Task Force on Clinical Competence, with both organizations separately or at times together producing additional policy statements and scientific advisories. To address quality, both organizations have developed robust cardiovascular registries. Get With The Guidelines (GWTG) is the lead quality-focused performance improvement initiative of the AHA and now includes over 2 million unique patient profile entries for individuals hospitalized with coronary artery disease, heart failure, and/or stroke in more than 1,400 hospitals, with emergency departments and outpatient/office practice programs now also accruing patient profiles. The National Cardiovascular Data Registry (NCDR), with over 11 million patient records in over 2,400 hospitals, is an ambitious and thriving effort of the ACC to capture clinical cardiovascular experience across the nation for acute coronary syndromes (ACS), cardiac catheterization and percutaneous coronary intervention, implantable cardioverter-defibrillators, carotid artery revascularization and endarterectomy procedures, pediatric and adult congenital heart disease treatment, practice innovation, and clinical excellence. The AHA and the ACC have created a true partnership in our acute coronary syndrome registry: ACTION-GWTG, also known as ARG. The creation of a singlenational ACS registry represents a huge success for our nation's hospitals, which until relatively recently had a smorgasbord of ACS registries to choose from, including proprietary registries supported by industry, GWTG-CAD (part of the AHA GWTG portfolio), and ACTION (part of the ACC's NCDR). This example of sublimating an organizational focus to aggregate the experience of the nation's hospitals and physicians has led to simplification and removal of confusion in the ACS registry landscape. The benefactor of this synergy is “Mission Lifeline,” an AHA initiative uniquely aligned with the joint ARG as a project to improve ST-segment elevation myocardial infarction care across the nation by focusing on the creation of novel care delivery models to increase access to timely primary percutaneous coronary intervention for ACS. ACC state chapters have embraced this AHA initiative as further evidence of the synergy between the 2 organizations.
How We Differ
As to the volunteers of the AHA and the ACC, “they are we,” and “we are they.” The leadership of each organization often is deeply involved in the activities of both organizations, as exemplified by our own dual membership and leadership in the ACC and the AHA. In fact, we are the rule rather than the exception. This shared profile extends beyond leadership at a national level and captures a very similar experience at the affiliate and division level (AHA) and at the state level (ACC). Because the ACC is a unique organization of cardiovascular professionals and the AHA is a voluntary health organization with a diverse constituency including cardiovascular professionals, basic and clinical investigators, patients, lay volunteers, business leaders, and children, one might expect that our organizations' approaches on certain issues would differ. Certain issues appropriately fall within the purview of a professional organization (e.g., cost and reimbursement policies), while others have greater emphasis by a voluntary health organization (e.g., advocacy for prevention and optimal patient care, clean air legislation, and food policy). Both the AHA and the ACC are strong advocates for research funding, cardiovascular prevention, public health policy, and issues surrounding health care reform. For example, the ACC has recently embraced the “Year of the Patient” and has developed online resources to support patient care. Similarly and importantly, advocacy for cardiovascular research remains a major contribution of the AHA along with the ACC, and the tireless efforts of many are intended to restore and increase National Institutes of Health–funded research. The ACC, recently making use of its mature registry structure, has received grant support in partnership with academic centers to pursue cardiovascular outcomes research. Both the ACC's NCDR and the AHA's GWTG experiences have led to multiple peer-reviewed publications that have served to change practice in the management of cardiovascular disease. Additionally, AHA-driven philanthropic support has funded 4 outcomes research centers to evaluate new methodology and train more outcomes researchers to accomplish this much-needed work, along with the additional support by the ACC for other cardiovascular research endeavors fulfilling important cardiovascular research gaps not met by government and industry.
The ACC and the AHA Going Forward
Increasing fiscal challenges for both organizations have created a unique landscape that has been difficult to navigate over the last 2 years; yet, the mission, purpose, and effectiveness of both organizations remain fully intact. For the time being, both organizations have adopted a “lean approach,” and certain program adjustments have been required. As we move forward, there are certain activities where appropriately both organizations remain separately engaged—unique in this consideration is the American Stroke Association, a division of the AHA that promotes science, advocacy, and increased awareness for stroke. Also unique here is the political action committee supported by the ACC and intended to advocate for issues directly pertinent to the practice of cardiology. As a 501c3 entity, the AHA is not allowed to operate a political action committee. Other timely issues are uniquely suited, however, for joint engagement. One such topic is the “relationship with industry” policies. We are striving for synergy in this important area, to strike a clear position of transparency while maintaining a productive work environment for volunteers engaged in efforts on behalf of the ACC and the AHA. We continue to seek other novel and appropriate areas that would best benefit from harnessing the power of our 2 organizations. This reduces inefficiency, saves time, and maximizes our joint resources. We believe that more “one voice” opportunities exist. If we constantly strive to view our programs and issues from the hospital, cardiovascular provider, and especially the patient perspective, we will invariably make wise decisions for both organizations and for the cardiovascular community.
Finally, should your day find you working with a staff person from the ACC or the AHA, please offer a genuine “thank you.” We are better organizations for their talent and extraordinary commitment to our missions. We would also like to personally thank you for your membership in the ACC and the AHA. We believe that as cardiovascular professionals we are better for our involvement with the ACC and the AHA. Most importantly, our patients benefit from the synergies we describe. Together, we are creating better health and accomplishing a greater good for those persons at risk for and affected by heart disease and stroke.
- American College of Cardiology Foundation