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 interventions and peripheral circulation from presentations at the European Society of Cardiology (ESC) Congress held in Barcelona, Spain.

The featured article concentrates on the newly released 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases. Changes from the 2011 guidelines include the use of a “vascular team” for multidisciplinary management, risk stratification for asymptomatic carotid disease, and a focus on lower extremity disease.

A number of highly anticipated and potentially practice-changing clinical trials were presented at ESC Congress 2017, including the results from the COMPASS study and a combined analysis of FAME 1 and 2. COMPASS extended the results from ATLAS TIMI-51, demonstrating that the combination of low-dose rivaroxaban (2.5 mg BID) plus aspirin was superior to aspirin alone for prevention of cardiovascular (CV) death, stroke, or myocardial infarction in patients with stable coronary artery disease (CAD) or peripheral arterial disease (PAD). In patients with PAD, the combination not only significantly reduced the primary outcome of major adverse cardiac events (MACE), but also significantly reduced the key outcome for PAD, major adverse limb events (MALE). The key composite of MACE or MALE or major amputation occurred in 6.3%, 7.6%, and 9.0% of patients receiving combination therapy, rivaroxaban alone, or aspirin alone, respectively. This represents an important advance for the treatment of patients with PAD.

The study, a subanalysis of FAME 1 and 2, that investigated whether the difference between fractional flow reserve (FFR) at baseline and post-percutaneous coronary intervention (PCI) impacts the 2 year vessel-oriented clinical events (VOCE) rate (vessel-related CV death, vessel-related revascularisation, and vessel-related myocardial infarction) found that a larger improvement in FFR was associated with a lower event rate, suggesting that reduction in ischaemic potential is an independent predictor of VOCE at 2 years.

In addition to the results from clinical trials and registry updates, you will also find information on selected areas of CV medicine including a dedicated look at the 2017 ESC Clinical Practice Guidelines focused update on dual antiplatelet therapy and at the management in patients with PAD who also have concomitant cardiac diseases, including CAD, atrial fibrillation, and heart failure.

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 Interventions and Peripheral Circulation 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