5 Minutes With….Geoffrey D. Barnes, MD, MSc
Welcome back to MedscapeLIVE! Cardiology E-News. Don’t miss your chance to register and get the Early Bird discount for the 2027 HOC at the OMNI in Fort Lauderdale at the end of this month—click here to register.
This month Dr. Geoffrey Barnes joins us to discuss the new 2026 AHA/ACC Acute PE guidelines—and its new clinical classification scheme, his JACC article, “A Field in Transition,” 2027 HOC topics—think the latest guideline recommendations, including lipid management and acute pulmonary embolism; the most challenging questions raised by patients—use of supplements, GLP receptor antagonists, and the latest anti-hypertensive medications; what’s coming that is good news for patients with acute PE; and emerging topic areas—like the use of factor XI inhibitors for ischemic stroke prevention, novel therapies for pulmonary artery hypertension, and transthyretin stabilizers for amyloidosis; and what’s new in his research on antithrombotic stewardship interventions.
Make sure to also check out this issue’s Pulse below, with articles from the Journal of the American Heart Association, Circulation, European Heart Journal, Medscape MedNews, Journal of the American College of Cardiology, Cardiology News, and the New England Journal of Medicine.
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January 29-31, 2027: The OMNI in Fort Lauderdale, Florida
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Thank you to Dr. Barnes for sharing his time and expertise! Please contact me at colleen@cmhadvisors.com with any comments and/or suggestions!
–Colleen Hutchinson
5 Minutes With….Dr. Geoffrey Barnes
Dr. Barnes is Associate Professor, Cardiovascular and Vascular Medicine, Frankel Cardiovascular Center, and Associate Chair, Department of Internal Medicine at the University of Michigan Medical School in Ann Arbor, Michigan. He serves as co-director for the Michigan Anticoagulation Quality Improvement Initiative (MAQI2) and as co-director for the Michigan Program on Value Enhancement (MPrOVE). His research is funded by the NIH, AHRQ, and Blue Cross-Blue Shield of Michigan. He serves in leadership roles with the Anticoagulation Forum, American College of Cardiology, and International Society on Thrombosis and Hemostasis and serves as program director for the University of Michigan Vascular Medicine fellowship training program. His areas of research interest include anticoagulation, venous thromboembolism, quality improvement and shared decision making, and he’s leading an NIH-sponsored study to improve the coordination and care of patients on chronic anticoagulants around the time of surgical procedures.
Can you tell us a bit about the 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline that you coauthored with colleagues? (The Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults)
Dr. Barnes: The 2026 AHA/ACC Acute PE guidelines were the very first guidelines in acute PE created by this multi-society group. They address all aspects of Acute PE diagnosis, risk stratification, and treatment. Perhaps most importantly, they introduce new risk classification categories that provide more granularity in risk of PE-specific adverse events which will guide both clinical decision-making and research.
Tell us about the new clinical classification scheme contained in the guideline, entitled “Acute Pulmonary Embolism Clinical Categories.”
Dr. Barnes: The new risk classification categories help clinicians better categorize patients according to their risk of PE-related adverse outcomes. Importantly, they distinguish between patients who are found to have asymptomatic, incidentally found acute PE from those who are symptomatic but have low risk of adverse events. They also provide more granularity in distinguishing with patients might be considered for acute PE intervention by introducing a category of “incipient cardiopulmonary failure”. Finally, they add a respiratory modifier to recognize when issues of oxygenation predominate.
You are a coauthor on “A Field in Transition,” recently published in JACC. The article states: “"...a gap remains between image-based improvement in cardiac function and patient-relevant clinical outcomes. Study designs have largely precluded assessment of mortality or functional morbidity, leaving the field with data that is encouraging but incomplete."
What do you see solving the gap?
Dr. Barnes: Before 2026, nearly all prospective, randomized trials of catheter-based interventions versus anticoagulation therapy in acute PE treatment focused on surrogate outcomes—such as improvement in RV to LV size ratio or improvement in PA systolic pressure. However, patients want to know if an intervention is going to make them feel better, prevent them from getting sicker, or prevent death. Those patient-centered outcomes did not exist previously. The good news is that several large, well-designed, prospective clinical trials are currently ongoing to fill that data void. The first, HI-PEITHO, was presented at ACC 2026 and published in the NEJM this year. Several others are likely to be completed within the next 12 to 24 months. Once these trials are complete, we’ll have a much better understanding of which patients are likely to benefit from catheter-based acute intervention, what types of catheter-based interventions are most effective, and (most importantly) what specific benefits patients can expect. It’s a very exciting time for clinicians and researchers who are involved in the care of patients with acute PE!
Is there other research you are involved in that you’re excited about?
Dr. Barnes: I spend a large portion of my time developing, implementing, and evaluating antithrombotic stewardship interventions. For instance, we just finished a randomized trial of different clinical decision support interventions within the electronic health record that aim to improve evidence-based anticoagulant prescribing and to quantify the benefit of engaging clinical pharmacists into clinical care.
The next HOC conference is January 29-31, 2027. What are things clinicians need the most guidance on now in cardiology and as Chair, how are you designing the HOC agenda to provide such needed direction?
Dr. Barnes: With the invention of artificial intelligence tools specific to clinic care, such as the Medscape AI tool, clinicians have ready access to a wealth of clinical information. In-person conferences, like the Heart of Cardiology meeting, help clinicians refine their skills in patient care - specifically, how to critically appraise clinical data and make decisions for patients with complex comorbidities. Furthermore, Heart of Cardiology attendees have the ability to network with fellow attendees and leaders in the field as we discuss challenging clinical cases and discuss how the latest guidelines are being integrated in our clinical practice.
Are there some legitimate debate topics that may be covered at the next HOC meeting?
Dr. Barnes: At the 2027 Heart of Cardiology meeting, we will dissect the latest guideline recommendations, including lipid management and acute pulmonary embolism. We will also explore some of the most challenging questions raised by our patients, including the use of supplements, GLP receptor antagonists, and the latest anti-hypertensive medications. Finally, we’ll explore emerging topic areas, including the use of factor XI inhibitors for ischemic stroke prevention, novel therapies for pulmonary artery hypertension, and transthyretin stabilizers for amyloidosis.
As President of the AC Forum, what do you foresee being some of the most critical focuses of the agenda for the 2027 AC Forum biennial conference?
Dr. Barnes: The 2027 AC Forum Biennial Conference in April 2027 will bring together national and international leaders in anticoagulation and thrombosis care with front-line clinicians who are leading antithrombotic stewardship programs and anticoagulation clinics. This meeting is an excellent opportunity for nurses, pharmacists, advanced practice providers, and physicians who care for anticoagulated patients to brush up on the latest trial data, learn about new practice models, and discuss the latest evidence in support of antithrombotic stewardship.
Heart of Cardiology | January 29 - 31, 2027 | Fort Lauderdale, FL | Register today for 20% OFF with code EARLYBIRD
We’re excited to announce the 7th Annual Heart of Cardiology Conference will take place January 29 – 31, 2027 at the brand new Omni Fort Lauderdale. The program will include focused educational sessions, a keynote presentation, informative bonus presentations, and a dedicated exhibit and poster hall to explore new research and tools. Designed for practicing clinicians, the conference will provide actionable insights to improve patient care and clinical decision‑making.You're invited to take advantage of a special 20% OFF discount! Simply use the code EARLYBIRD at checkout. Register Now!
Check out the highlights from the 2026 conference.
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