ESC Congress 2018 — Hot Science tips from the programme chairperson

Covering a wide range of topics, from nutrition to late breaking clinical trials that will change practice, ESC Congress 2018 has a hot story for everyone.

Professor Stephan Achenbach, Chairperson of the ESC Congress Programme Committee and ESC President Elect gives a taste of what's in store. "I am really excited about the trials that will be presented at ESC Congress 2018," he said. "The results are set to have a big impact, either because they affect large population groups or involve innovative treatments."

Two blockbuster trials of aspirin for preventing first heart attacks and strokes will be presented – the ARRIVE trial in more than 12,000 individuals at moderate risk and the ASCEND trial in more than 15,000 patients with diabetes – and will be of particular interest to the press.

"We had assumed that taking aspirin can only be good for you, and what's the harm?" said Professor Achenbach. "But then we discovered that while aspirin can protect against heart attacks and stroke, it causes bleeding. So it's not at all clear who will actually benefit from taking aspirin to prevent a first heart attack or stroke. These two trials will shed light on this issue, impacting many millions of people worldwide."

It's not just how much we eat, but what we eat that matters for heart health and longevity. The PURE study looked at what constitutes a healthy diet in over 200,000 people from more than 50 countries. Professor Achenbach said: "The results will give us new insights on the relationship between the types of food we eat – for example fruit, vegetables, nuts, dairy products and meat – and health and disease."

Journalists should also stay tuned for the 2018 guidelines on hypertension. Produced by the European Society of Cardiology and European Society of Hypertension, these will also be of particular interest to the medical press, given last year's release of American guidelines. Professor Achenbach said: "The American guidelines were very strict and lowered the definition of high blood pressure. It will be exciting to see what the Europeans say about what blood pressure qualifies as 'high' and how strictly it should be treated."

The MARINER trial will reveal whether potentially fatal blood clots can be prevented in acutely ill patients by continuing to give them oral anticoagulation therapy when they return home. "Treating patients after discharge is a completely new concept and could affect the millions of people hospitalised every year with heart attack, pneumonia, or broken bones," said Professor Achenbach.

Also on the oral anticoagulation theme, the COMMANDER HF trial is set to show whether these drugs improve survival and reduce heart attack and stroke in patients with heart failure who do not have atrial fibrillation. Professor Achenbach said: "This is a massively large patient group that has so far not been considered for oral anticoagulation unless they have atrial fibrillation and the trial could change our approach to their management."

There are numerous trials of devices and drugs to interest the media. Professor Achenbach highlights the MITRA.fr study which will show whether treating the mitral valve with a device inserted via a catheter is advantageous in patients with heart failure.

An entire late breaking science session is devoted to transcatheter aortic valve implantation (TAVI) and is aligned to the congress spotlight, Valvular Heart Disease. This includes the LRT Clinical Trial and GARY registry in low-risk patients, the TAVI-PM post-mortem study on the durability of TAVI, and five-year follow-up from the FRANCE-2 Registry which will report on clinical outcomes and valve durability in high-risk patients.

Major drug trials include ATTR-ACT, which assessed the efficacy and safety of tafamidis in transthyretin amyloid cardiomyopathy, a condition that currently has few treatment options. The High-STEACS trial of more than 47,000 patients will reveal whether using high-sensitivity troponin to confirm the diagnosis in those with suspected heart attack leads to more or less deaths and repeat heart attacks after one year.

Voted ESC President Elect for 2018 to 2020, Professor Achenbach said: "I'm excited by how diverse cardiology is and feel it is my responsibility to represent and balance the needs of the cardiologists, healthcare providers and researchers in every country that belongs to the ESC and also across the entire spectrum of cardiovascular disease."

One of his top priorities will be communications – getting the message out about scientific findings from ESC journals and registries, guidelines, congresses, and other educational activities. "This will tremendously help to achieve the ESC's mission to reduce the burden of cardiovascular disease," he said. "We should use every channel of communication according to its best purpose – journalists coming to the congress have an important role in disseminating the latest research and social media is an effective way to alert people about our scientific news and activities."

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