Tag Archives: European Society of Cardiology

European Society of Cardiology (ESC) guidelines recommend low-density lipoprotein (LDL) below 1.4 mmol/L in patients post ACS, which differs from UK National Institute for Health and Care Excellence (NICE) guideline recommendations of 1.8 mmol/L and 1.4 mmol/L in very-high-risk patients only.6,7 The fifth European survey of Cardiovascular Disease prevention and Diabetes (EUROASPIRE V) survey showed that only 30% of post-ACS patients had low-density lipoprotein cholesterol (LDL-C) levels <1.8 mmol/L one year after discharge.8 The ACS EuroPath survey showed a considerable lack of physicians’ compliance with guidelines in managing lipid low

ESC President, Professor Barbara Casadei Heart failure highlights PARAGON-HF fails primary end point but benefits for some Heart failure was a key theme of this year’s congress, accounting for more than 1,000 presentations. In the first hotline session of the Congress, the keenly awaited results from PARAGON-HF (Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction) were presented.1 Up to 64 million people worldwide have heart failure, and that number is rising as the population ages. Evidence-based treatment has focused on about half of these patients who have heart failure with reduced ejection fraction (<

British Heart Foundation The biggest independent funder of cardiovascular research in the UK, The British Heart Foundation plays a leading role in the fight against diseases of the heart and circulation by support of vital, pioneering research into their causes, prevention, diagnosis and treatment through research grants. It funds around £100 million of heart research every year. https://www.bhf.org.uk/research/information-for-researchers British Cardiovascular Society/BJCA The British Cardiovascular Society is a registered charity that aims to support and represents those working in cardiovascular care and research, by providing access to t

New practical NOACs guide A new version of EHRA Practical Guide on the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) was launched at the congress. ESC guidelines state that NOACs should be preferred over vitamin K antagonists, such as warfarin, for stroke prevention in AF patients, except those with a mechanical heart valve or rheumatic mitral valve stenosis, and their use in clinical practice is increasing. The guide gives concrete, practical advice on how to use NOACs in specific clinical situations. The guide is published in European Heart Journal (doi: 10.1093/eurheartj/ehy136). Anti

CANTOS: a focus on inflammation and atherosclerosis A consistent criticism of the ESC congress in recent years has been that, outside of the chronic heart failure arena at least, the late breaker sessions have lacked headline-grabbing, big-hitting landmark trials. Not this year. “This is our 1994!” proclaimed chief investigator, Paul Ridker (Brigham and Women’s Hospital, Boston, USA), on presentation of the results of CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study), drawing parallels with the practice-changing impact of the 4S (Scandinavian Simvastatin Survival Study) trial, which demonstrated the efficacy of statins

Atherosclerosis has long been characterised as a chronic inflammatory condition. Elevation of the non-specific inflammatory marker high sensitivity c-reactive protein (hs-CRP) is an accepted predictor of adverse cardiovascular events and its reduction in JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) and other statin trials has been linked with improved outcomes, even with low-density lipoprotein (LDL) cholesterol levels within the normal range.1 Although a specific aetiological link has proven harder to delineate, the cytokine interleukin 1β (IL-1β), pro-inflammatory messenger of

Over a mean follow-up of 23 months, there was a marked decrease in the primary composite end point of cardiovascular death, stroke, or myocardial infarction in the combination therapy group by 24% (hazard ration [HR] 0.76; 95% CI 0.66-0.86; p<0.001) over aspirin monotherapy, and improved survival by 18%. The trial terminated prematurely by the data monitoring committee due to due to overwhelming efficacy. Rivaroxaban monotherapy showed no efficacy benefit. The anticipated trade-off was apparent with increased major bleeding in the combination therapy arm (HR 1.70, 95% CI 1.40–2.05; p<0.001), although fatal and intracranial bleeds wer

Approximately 20–30% of patients with AF, who are continuously taking an oral anticoagulant to reduce their risk of AF-related stroke, have coexisting coronary artery disease and may require PCI. The current practice of administering triple therapy with warfarin and two antiplatelet agents in patients with AF after a PCI is associated with high rates of major bleeding. RE-DUAL PCI tested an alternative treatment strategy: dual therapy with dabigatran and a single antiplatelet agent (P2Y12 inhibitor). Selected for one of the meeting’s hotline sessions and simultaneously published in the New England Journal of Medicine (https://doi.org/10.

Presented in a hotline session by Dr Martin Landray (University of Oxford), the trial’s co-principal investigator, and simultaneously published in the New England Journal of Medicine (https://doi.org/10.1056/NEJMoa1706444), this large-scale, placebo-controlled study was carried out on 30,449 patients with cardiovascular disease, who were all receiving lipid-lowering treatment with atorvastatin. Those patients also receiving anacetrapib (100 mg once daily) showed a significant reduction in the primary outcome, the risk of major coronary events (coronary death, myocardial infarction or coronary re-vascularisation) by 9% relative to those pati

Presenters included cardiologists, Professors Michael Boehm (University of the Saarland, Homburg, Saarland, Germany) and Stefan Anker (University Medical Center Göttingen, Göttingen, Germany) and nephrologist, Matthew Weir (University of Maryland Medical Centre, Baltimore, Maryland, USA). Their presentations are summarised below. The addition of mineralocorticoid receptor antagonists (MRAs) to angiotensin converting enzyme (ACE) inhibition or receptor blockade (ARB) has been shown in randomised-controlled trials to improve morbidity and mortality in patients with heart failure.1,2 In the EMPHASIS-HF study, the addition of eplerenone in pat