Letter from the Advisory Board

Dear Practitioner,

We are pleased to share with you this special issue of ESC Congress in Review 2017 with a focus on coronary artery disease (CAD) and acute coronary syndromes (ACS) from presentations at the European Society of Cardiology (ESC) Congress 2017 held in Barcelona, Spain.

The featured article reviews the newly released 2017 ESC Clinical Practice Guidelines for the Management of Acute Myocardial Infarction (MI) in Patients Presenting with ST-segment Elevation (STEMI). Changes from the 2012 guidelines include new sections dedicated to MI with nonobstructive coronary arteries; an update on caring for patients in the acute phase of MI; a change in the timing of primary percutaneous coronary intervention (PCI) and fibrinolysis now sets the start of the “strategy clock” at the time of STEMI diagnosis rather than first medical contact; and the use of longer-term therapies after STEMI.

A number of highly anticipated and potentially practice changing clinical trials were presented at ESC Congress 2017, including the results from the COMPASS and RE-DUAL PCI studies. COMPASS extended the results from ATLAS TIMI-51 demonstrating that the combination of rivaroxaban 2.5 mg BID plus aspirin was superior to aspirin alone for prevention of cardiovascular death, stroke, or MI in patients with stable CAD or PAD. There was a trade-off with more bleeding when low-dose anticoagulant was added to aspirin, but fortunately severe bleeding was not increased.

Triple antithrombotic therapy comprising warfarin plus dual antiplatelet therapy is standard care after PCI for patients with AF, but this combination can leave these patients at high risk for bleeding events. REDUAL PCI was designed to investigate the efficacy and safety of dual therapy with dabigatran and a P2Y12 inhibitor in AF patients after PCI compared with standard triple therapy. Results showed that among patients with AF undergoing PCI, dual therapy was safe and effective at reducing bleeding events compared with triple therapy (absolute risk reduction of 11.5% for the 110 mg dose and 5.5% for the 150 mg dose).

In addition to the results from clinical trials and registry updates, you will also find articles that discuss the use of pharmacotherapy after STEMI and P2Y12 inhibitors for the treatment of ACS.

We hope that you find the articles and practical perspectives that are contained in this special edition of ESC Congress 2017 in Review – Focus on CAD & ACS helpful in integrating this new information into your clinical practice.

 

Robert P. Giugliano, MD, SM
Cardiovascular Division Brigham and Women’s Hospital
Associate Professor in Medicine Harvard Medical School
Boston, MA, USA

Marc P. Bonaca, MD, MPH
Cardiovascular Division Brigham and Women’s Hospital
Assistant Professor in Medicine Harvard Medical School
Boston, Massachusetts, USA

Jacob A. Udell, MD, MPH
Cardiovascular Division Women’s College Hospital
Toronto General Hospital
Assistant Professor of Medicine University of Toronto
Toronto, Ontario, Canada

Nihar R. Desai, MD, MPH
Cardiovascular Division Yale-New Haven Hospital
Assistant Professor Medicine Yale School of Medicine
New Haven, Connecticut, USA

Matthew Cavender, MD, MPH
Assistant Professor of Medicine
University of North Carolina
Chapel Hill, North Carolina, USA

Erin A. Bohula May, MD, PhD
Cardiovascular Division Brigham and Women’s Hospital
Instructor in Medicine Harvard Medical School
Boston, Massachusetts, USA

Giulia Magnani, MD, PhD
Cardiovascular Division Parma University Hospital
University of Parma, Parma, Italy

Carlos Aguiar, MD, FESC
Department of Cardiology
Hospital de Santa Cruz
Carnaxide, Portugal

Jan Steffel, MD, FESC, FHRS
Department of Cardiology
University Heart Center Zurich
University Hospital Zurich
Zurich, Switzerland



Posted on 30 August 201717 March 2021