ESC, Barcelona 2017

Fausto J. Pinto, FESC, FACC

Immediate Past President of the ESC
Head of Cardiology, University Hospital Sta Maria, Universidade de Lisboa, Lisboa, Portugal


Barcelona once again welcomed the ESC congress. Despite the terrible events that occurred in the city
just 1 week before the start of the congress, the medical community demonstrated an enormous sense
of unity and responsibility toward the future, which is the only way that we should respond to such disgraceful
The ESC congress is currently the largest meeting of the cardiovascular community worldwide. This year,
32 000 delegates came to Barcelona and experienced one of the most successful meetings ever organized.
Certainly, every person that attended the meeting left Barcelona more enriched scientifically, with a few
more answers to some of the clinical problems we face every day as cardiologists, as well as answers to
some of the questions we still have regarding pathophysiology, mechanisms of disease, and new modalities
for diagnosis and treatment of cardiovascular diseases. An enormous and beautifully organized
exhibition provided the opportunity for everyone to enjoy the latest news coming from the industry, both
pharmaceutical and devices.

One of the main features of the ESC congress is to provide delegates from around the world with the opportunity
to present new science. This year, more than 11 000 abstracts were submitted and more than
4000 were selected for presentations. Japan was once again the leader in abstract submissions and acceptance.
The ESC congress was comprised of 796 sessions, including the highly anticipated hotlines,
clinical trial updates, registries, guidelines, abstract-based program, as well as a large number of symposiums,
joint sessions, and many others. It was organized into nine villages, each one representing a major
field in cardiovascular medicine:
Basic science; Hypertension; Cardiac imaging; Prevention; Arrhythmias; Interventions; Valvular disease;
Coronary artery disease; Heart failure (chronic and acute).

This year, the spotlight was on the 40th anniversary of coronary angioplasty; therefore, percutaneous
coronary interventions were the focus. During the 5 days of the congress, a space was dedicated to percutaneous
coronary interventions, including a whole set of different presentations, including “Live in a Box”
sessions that featured clinical cases and interventional procedures from leading cardiovascular centers
to illustrate the new advancements in percutaneous coronary interventions.

Four new guidelines were presented at this year’s congress, including guidelines for (i) ST-segment elevation
myocardial infarction; (ii) valvular heart disease; (iii) peripheral artery disease; and (iv) the use of
dual antiplatelet therapy.

In this issue of Dialogues in Cardiovascular Medicine, you will have the opportunity to read short texts
from experts in the different fields of cardiovascular medicine who summarized the main novelties and
practical clinical implications that were presented at the 2017 ESC congress. Kim Fox provides a snapshot
of all cardiology research articles published this year between January 1st and June 30th in the two
most prestigious medical journals, the Lancet and the New England Journal of Medicine. A whole series of
Expert Opinions follows, which are written by leaders in the respective fields. This section will be followed
by summaries of late-breaking science in heart failure, imaging, and ESC registries. This issue will close
with a series of hotlines on registries, atrial fibrillation, and the prevention and outcomes in coronary artery
disease. Altogether, several important messages came out of the ESC congress in Barcelona in these
different fields.

During the congress, many trial results were discussed, and some of those presented will likely have an
impact on clinical practice. The following list contains just a few examples of what will be discussed in the
different articles:

  • The COMPASS trial showed that, in patients with a history of coronary artery disease and peripheral
    artery disease, intensifying therapy by adding rivaroxaban to aspirin provides a net clinical benefit.
  • The CANTOS trial showed that, in patients after an acute myocardial infarction, canakinumab, an anti–
    IL-1β agent, reduced the overall major adverse cardiac events by 15% and, surprising, death from any
    cancer by 51%.
  • The Re-DUAL PCI trial showed that, when compared with triple therapy, dual therapy with dabigatran
    and a P2Y12 inhibitor is superior regarding the risk reduction in bleeding and noninferior regarding
    thromboembolic events.
  • The GLAGOV trial showed that, when added to a statin, evolocumab, a PCSK-9 inhibitor, induces plaque
    regression, but does not change the composition of the plaque.
  • The PURE study, a prospective cohort study, which analyzed a general population of over 135 000 people
    from 18 different countries, showed that dietary fats are protective and carbohydrates are harmful;
    the results of which are challenging the current guideline recommendations on the intake of saturated
    fat and carbohydrates.
  • The CLARIFY registry of 32 703 patients with stable coronary artery disease and hypertension showed
    a J curve, where patients had a 40% to 50% increase in their cardiovascular risk with a systolic blood
    pressure <120 mm Hg and a diastolic blood pressure <70 mm Hg.

We really hope you will enjoy reading the different contributions from colleagues around the world, leaders
in their field of expertise. We are looking forward to seeing you next year in Munich, Germany for
another successful ESC congress.