The European Society of Cardiology (ESC) meeting this week will unveil the latest findings in cardiovascular medicine, including a highly-anticipated statin trial and several studies poised to advance heart attack triage and care.
ESC will run from Friday, August 28 to Monday, August 31 and host 12 "hot line" scientific sessions. The hybrid conference is being held this year in Munich, Germany, with livestreaming also available.
Featured in a Saturday hot line session is STAREE, the first major randomized trial to report whether primary prevention statins help survival and cardiovascular outcomes in people age 70 or older.
With its nearly 10,000 participants, STAREE is expected to provide some answers to clinicians still unsure whether these statins should be used in routine practice in relatively healthy older people with no history of atherosclerotic cardiovascular disease. Considered a cornerstone cardiovascular preventive therapy, statins have nevertheless been tied to possible side effects such as muscle pain and fatigue, hence the longstanding controversy over their routine use.
"This large trial addresses a very common dilemma in clinical practice -- should we give statins to healthy people aged over 70 years to reduce the risk of cardiovascular events and survival free of dementia? The results from STAREE will have direct relevance to millions of older adults and their clinicians," said Tomasz Guzik, MD, PhD, of the University of Edinburgh in Scotland, in an ESC press release.
Major contributions to the field of acute myocardial infarction (MI) are also highlighted in the ESC program.
On Saturday, the audience will see whether there is a way forward for milvexian in acute coronary syndrome with the full report of LIBREXIA ACS. Milvexian -- notable for belonging to the next-generation factor XIa inhibitor antithrombotics expected to be safer than current oral anticoagulants -- is known to have failed at reducing major adverse cardiovascular events among recent heart attack survivors, resulting in LIBREXIA ACS being stopped early.
As for other major MI studies, AMUNDSEN, a randomized study of PCSK9 inhibitor evolocumab (Repatha) before percutaneous coronary intervention for acute MI, also takes the spotlight on Saturday, as does the PRESC1SE-MI trial analyzing whether the ESC's rapid 0/1-hour troponin algorithm is good enough for the diagnosis of MI in the emergency department setting.
The field of atrial fibrillation (Afib) has its fair share of exciting trial reports as well.
Up first is Friday's SINGLE-AF trial presentation on direct oral anticoagulant therapy for people with Afib and intermediate stroke risk, a wider pool of drug candidates. On Sunday, the ESC audience will also see results of the sham-controlled PVI-SHAM-AF trial regarding pulmonary vein isolation for Afib and the NEXAF randomized trial testing a 12-month exercise routine among people with paroxysmal or persistent Afib.
Meanwhile, an effective therapy in symptomatic nonobstructive hypertrophic cardiomyopathy (HCM) finally emerges with ACACIA-HCM. According to topline results announced this spring, aficamten (Myqorzo) reportedly met its primary endpoints as a treatment for the underlying cardiac muscle hypercontractility in this disease -- bringing renewed hope following a previous failure by mavacamten (Camzyos), another cardiac myosin inhibitor. The full results of ACACIA-HCM will be presented Friday morning.
In addition to the major trial presentations, the ESC conference will showcase the Fifth Universal Definition of MI plus three new guidelines: one each for heart failure management, cardiac rehabilitation, and the dual management of cardiovascular and chronic kidney disease.
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