ESC Congress 2023 - highlights from Hot Line programme

European Society of Cardiology

Get ready for the most highly anticipated cardiovascular science of the year at ESC Congress 2023, the world's largest cardiology event.

The packed Press Conference programme launches on Thursday, 24 August at 11:30 CEST. Join the ESC President, Congress Programme Chair and ESC Communication Committee Chair in person or online for a preview of what's to come. Also on Thursday: the first embargoed Hot Line Press Conference, starting at 16:00 CEST. Friday showcases the Burden of Cardiovascular Disease in a dedicated Press Conference at 13:00 CEST, followed by two Hot Line Press Conferences. There's more to come on Saturday and Sunday, with each featuring three embargoed Hot Line Press Conferences.

A total of nine Hot Line Press Conferences will provide the first glimpse of the results of 30 major studies in cardiovascular disease, with a chance to quiz the investigators behind them. Only accredited media can access embargoed Press Conferences: get accredited now. Hot Line studies will be presented in Amsterdam and broadcast live online. Tune in here. Professor John McMurray, ESC Congress Programme Committee Chair, said: "Hot Lines are the most eagerly awaited sessions and where the energy of ESC Congress is at its highest. They are the highlight of our Late Breaking Science track, which also includes the Clinical Trial Updates and Registries sessions."1

Professor McMurray made special mention of the trials in Hot Line 1, which kicks off with STEP HFpEF, a trial comparing the effects of once-weekly semaglutide in people with heart failure with preserved ejection fraction (HFpEF) and obesity. "This is a treatment targeting a common and increasing comorbidity in this type of heart failure," he said. "Obesity is associated with much worse symptoms and functional capacity and a higher risk of hospitalisation. We hope reducing obesity will help patients with HFpEF." NOAH-AFNET 6 examines oral anticoagulation in patients with atrial high-rate episodes. Professor McMurray said: "This trial attempts to answer the very important clinical question of whether we should use anticoagulant therapy in patients with brief episodes of atrial fibrillation (AF). We know that sustained AF leads to a high risk of stroke, which can be effectively and safely (with respect to bleeding) reduced by treatment with an anticoagulant – but is this also true for short episodes of AF? The session concludes with COP-AF. "AF and myocardial injury are common complications of thoracic surgery and are associated with high risks of death, stroke and longer hospital stays. Inflammation may play a role in causing these complications and colchicine has anti-inflammatory activity recently shown to be of benefit in patients with coronary artery disease. This large trial has tested whether starting colchicine pre-operatively reduces the risk of these complications," said Professor McMurray.

Professor McMurray also emphasised HEART-FID, which will be presented in Hot Line 2. "Iron deficiency is very common in patients with heart failure and reduced ejection fraction (HFrEF) and intravenous iron seems to improve symptoms and exercise tolerance," he said. "However, the AFFIRM-HF and IRONMAN trials have left some uncertainty about the effects of this therapy on hospitalisation and mortality. HEART-FID is by far the largest trial to date using this treatment. In this Hot Line we will also have a meta-analysis of this new trial and prior trials – Effects of FCM on recurrent HF hospitalisations: an individual participant data meta-analysis – which will hopefully provide definitive conclusions about the role of this therapy in HFrEF."

"Hot Line 4 is very important and will probably be the highlight of the Hot Lines for many cardiovascular health professionals. It includes a series of trials – ILUMIEN IV, OCTIVUS and OCTOBER – comparing optical coherence tomography (OCT)-guided, intravascular ultrasound (IVUS)-guided and angiography-guided percutaneous coronary intervention (PCI). In this session we will also have a real-time updated network meta-analysis presented, hopefully again providing the definitive evidence to guide the optimal approach to PCI."

"Additional exciting trials will cover acute coronary syndromes and coronary intervention, AF (ablation and anticoagulation), acute and chronic heart failure, pacing and cardiac resynchronisation therapy (CRT), cardiac arrest and resuscitation, shock, amyloidosis, myocarditis, cardiovascular oncology and COVID-19," said Professor McMurray. "Don't miss this year's outstanding Hot Line programme."

Also not to miss: five ESC Clinical Practice Guidelines will be published on 25 August at 08:30 CEST covering a wide range of topics in cardiovascular medicine. Including the first international Guideline covering all cardiomyopathy subtypes, plus recommendations on acute coronary syndromes, management of cardiovascular disease in patients with diabetes, management of endocarditis and a focused update of the 2021 Heart Failure Guidelines, which takes into account rapidly emerging new evidence on the treatment of patients with HFpEF or heart failure with mildly reduced ejection fraction.

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