EDITORIAL
Joint efforts across national boundaries between professional organizations in cardiovascular medicine: one way into the future
George A. Beller, MD, FACC, President American College of Cardiology* and
Lars Rydén, MD, FACC, FESC, President European Society of Cardiology
* Cardiovascular Division, Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden
Reprint requests and correspondence: George A. Beller, MD, FACC, Cardiovascular Division, Department of Internal Medicine, University of Virginia Health System, P.O. Box 800158, Charlottesville, Virginia 22908-0158. Lars Rydén, MD, FACC, FESC, Department of Cardiology, Karolinska Hospital, 171 76 Stockholm, Sweden
Medicine is international in the truest sense. With one of its origins in the Hippocratic oath, the practice of modern medicine has as its foundation the commitment of physicians to treat the sick to the best of their ability. Moreover, this commitment means that physicians in every country are to care for the sick without considering race, religion, socioeconomic class, or political persuasion of their patients.
Now, more than ever before, we have witnessed an openness and cooperative spirit in the medical world that has broken down closed international barriers. The initial visits of physicians from the U.S. to the former U.S.S.R., and from the western world into the previously isolated Republic of China, employed medical professional contacts to engender mutual trust. Although historically not always true, the art and science of medicine can now basically be disseminated without geographic restrictions. Combined with the recent and remarkable innovations in the field of electronic communication via the Internet, new and important medical knowledge is now globally available within amazingly short periods of time following discovery and scientific reporting. Thus, medicine has in many ways paved the way for global cooperation by its mere nature of serving the sick, whoever and wherever the sick individual resides.
Despite the progress made, in many fields of medicine even greater cooperation and deeper relations can be achieved. The American College of Cardiology (ACC) and the European Society of Cardiology (ESC), two of the most distinguished professional organizations in cardiovascular medicine, have realized this challenge and acted accordingly. Several years ago, together with the American Heart Association (AHA), an initiative was taken to conduct joint leadership meetings of the three organizations biannually to discuss topics that would be appropriate to undertake for the benefit of patients with cardiovascular disease. Initial emphasis was made in understanding each organization and its culture, traditions, and objectives. Although there are many historic, cultural, and linguistic differences within Europe and between Europe and the U.S., the three organizations’ similarities in vision and goals formed the basis of planning collaborative activities—with the ultimate goal being to improve patient care worldwide and reduce mortality and morbidity from cardiovascular disease.
With this cooperative spirit achieved, we believe that the words comprising the title of this editorial, "Joint Efforts Across National Boundaries Between Professional Organizations in Cardiovascular Medicine: One Way Into the Future," will become an increasingly more obvious reality in the new millennium. There are many areas in which duplication of work among scientific organizations is apparent and where combined efforts make better use of limited resources, so that more initiatives of value for enhancing cardiovascular care can be launched. Practice guidelines, educational products, methodologies for distribution of new knowledge in a timely manner, and mutually agreed-upon nomenclature and definitions of disease entities are just some examples of areas in which cooperation of societies across the world will be of benefit.
This issue of the Journal of the American College of Cardiology (JACC) contains a report from the first Heart House to Heart House conference. The document is published jointly in JACC and the European Heart Journal. Under the leadership of Drs. Joseph Alpert from the ACC and Kristian Thygesen from ESC, a group of U.S. and European experts assembled at the European Heart House in southern France in July 1999 to redefine the criteria for diagnosis of acute myocardial infarction. Having the diagnostic criteria of this common entity be uniform across the globe has major implications not only for the individual patient but also for any given country that wants to track the incidence of acute myocardial infarction in relationship to its incidence in other countries. The availability of this uniform definition of acute myocardial infarction will have an impact on world health considerations. When the incidence of myocardial infarction is tracked worldwide, it will be with the knowledge that all of the countries are employing the same definition. There could not have been a more suitable topic for cooperation between societies on opposite sides of the Atlantic Ocean.
As presidents of our respective societies, our objective is not to comment on or to critique this document. Its contents are self-explanatory. We, as the representatives of two large professional organizations in cardiovascular medicine, are proud of this effort and the resulting document. We are taking this opportunity to congratulate our predecessors for undertaking the planning initiatives that led to the first Heart House to Heart House conference. It has paved the way to other collaborative activities. A second conference, in which the AHA will also participate, will tackle the problems of ethical and conflict-of-interest issues in clinical research, delivery of continuing medical education, and the practice of cardiovascular medicine. Planning is already under way for the second Heart House Conference. Experts in the fields of ethics, law, entrepreneurism in science and medicine, and physician–industry relationships will gather with representatives of the cardiovascular physician community representing the three cardiovascular organizations to develop a consensus document in this timely area of concern to professionals and society in general.
Another example of enhanced relationships among major cardiovascular organizations is the ACC/AHA/ESC Committee to Develop Guidelines on the Management of Patients With Atrial Fibrillation, which is the first truly officially appointed group of professionals creating practice guidelines jointly on behalf of the three organizations. A final report is due by March 2001.
Yet another example of a cooperative activity currently under way is to provide seamless electronic access among cardiology journals published by the ACC, the AHA, and the ESC. These ventures are just the beginning of what will obviously be a long process of joint initiatives. There are many other areas in which our three organizations—together with other cardiovascular specialty and subspecialty societies—might undertake joint ventures, ultimately for the benefit of individual patients and populations. The field of cardiovascular prevention is one area where the global cooperation of specialty societies throughout the world will be of paramount importance. The ACC, the ESC, and the AHA are supporting work by the World Heart Federation to inaugurate a Forum for Global Cardiovascular Disease Prevention. Although prevention guidelines are already available in the U.S. and Europe, they will not be of great value until they are fully implemented. From a worldwide perspective, physicians across the globe with common interests should unify through their professional organizations to fight the battle against cardiovascular disease.
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