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The European Society of Cardiology (ESC) concluded its annual congress in Munich on August 31, which attracted more than 33,800 attendees from over 150 countries, both in person and online, according to the society's congress hub. ESC Congress 2026 presented a record 59 late-breaking trials across 12 Hot Line sessions, along with three new clinical practice guidelines and the 5th Universal Definition of Myocardial Infarction, developed in collaboration with the American College of Cardiology, the American Heart Association, and the World Heart Federation.
The guidelines garnered significant attention. The 2026 heart failure guideline updated the terminology from "acute heart failure" to "decompensated heart failure" and categorized guideline-directed medical therapy into foundational and additional tiers. Additionally, the society introduced its first joint guideline with the European Renal Association focusing on cardiovascular disease and chronic kidney disease, along with a new cardiac rehabilitation document.
Among the Hot Line sessions, the STAREE trial addressed a longstanding primary-prevention question. This trial randomized 9,971 adults aged 70 years and older without known cardiovascular disease to receive either atorvastatin 40 mg or a placebo. Major cardiovascular events were reported in 6.0% of the statin group compared to 8.3% in the placebo group over a median of 5.9 years, although disability-free survival did not show significant improvement. The SINGLE-AF trial, the first randomized study involving atrial fibrillation patients at intermediate stroke risk, indicated a preference for anticoagulation over no treatment. Conversely, the factor XIa inhibitor milvexian did not meet its primary endpoint in the LIBREXIA ACS trial, and eplontersen did not meet expectations in the CARDIO-TTRansform amyloid cardiomyopathy trial. Aficamten displayed positive outcomes in nonobstructive hypertrophic cardiomyopathy in the ACACIA-HCM trial. Artificial intelligence was featured prominently throughout the congress, encompassing discussions on imaging, ECG interpretation, and risk prediction.
Registered delegates can access on-demand presentations until September 15, after which the content will be available on the ESC 365 platform for members. The society announced that ESC Congress 2027 will take place in Milan from August 27 to 30.
