The congress featured over 1,750 sessions and 12 Hot Line sessions highlighting practice-changing findings in cardiovascular science. ESC Congress 2026 also released three clinical practice guidelines and the Fifth Universal Definition of Myocardial Infarction.
Left atrial appendage closure during open-heart surgery is recommended for high-risk patients undergoing cardiac surgery to reduce stroke risk. The LAACS-2 trial found closure provided a 56% reduction in stroke risk for those at high risk, but no significant benefit for those at lower risk.
A large randomized trial and meta-analysis found that immediate coronary angiography does not improve 30-day survival in patients with out-of-hospital cardiac arrest without ECG ST-elevation. The findings support current guideline recommendations against routine immediate coronary angiography in these patients.
A new study found that community first responders did not improve short-term survival after cardiac arrest, but did increase bystander CPR and defibrillation rates. The study's findings suggest that the effect of first responders on survival is highly dependent on the time available for intervention.
A new study has shown that catheter-directed thrombolysis significantly reduces primary clinical outcomes in patients with pulmonary embolism, including a lower rate of cardiorespiratory decompensation or collapse. The treatment improved short-term clinical outcomes compared to standard anticoagulation therapy alone.
Two imaging techniques, optical coherence tomography (OCT) and intravascular ultrasound (IVUS), were compared in patients with true distal left main bifurcation lesions. OCT was found to be noninferior to IVUS in guiding stenting, suggesting it may be an alternative option.
The CorCal Outcomes trial found no difference in major cardiovascular events when statin initiation was based on coronary artery calcium compared to traditional risk factor assessment. Patients recommended statins based on CAC scores were more adherent with their medication.
The EVAOLD trial suggests that routine invasive treatment is more effective than a selective approach in older patients with NSTEMI, a common type of heart attack. The trial found that the selective approach did not demonstrate noninferiority to routine invasive treatment for major cardiovascular events.
A 14-day wearable ECG monitor improved the diagnosis and treatment of arrhythmias in patients with unexplained syncope. Monitoring more than doubled the detection of clinically significant cardiac arrhythmias and led to earlier diagnosis, resulting in a 50% reduction in all-cause mortality.
A large randomised trial found that targeted lead placement in cardiac resynchronisation therapy did not improve outcomes in patients with heart failure. The study compared targeted and standard lead placement and found no difference in death or first heart failure hospitalization rates.
A one-year tailored exercise program significantly reduced atrial fibrillation (AF) burden and improved cardiorespiratory fitness in patients with non-permanent AF. Despite lack of significant improvements in quality of life, the exercise intervention showed meaningful benefits in measures of fitness and hospitalisations.
Plozasiran administered by subcutaneous injection every three months has shown substantial reductions in triglyceride levels, with a 78-80% decrease observed after one year. The treatment also demonstrated a significant reduction in acute pancreatitis events, with a 78% decrease in trial populations.
A recent study found that catheter ablation does not significantly improve quality of life related to atrial fibrillation, but reduces AF recurrence. The PVI-SHAM-AF trial showed that both catheter ablation and a sham procedure improved AF-related quality of life, with no significant difference between them.
A community-based trial in rural China found that intensive blood-pressure lowering intervention reduced dementia risk by 15% compared to usual care. The intervention also showed benefits in cognitive impairment and serious adverse events. This scalable approach may help reduce the increasing burden of dementia globally.
A new study finds that a TAVI-first strategy is noninferior to a PCI-first strategy in patients with severe aortic stenosis and concomitant coronary artery disease. The trial showed that fewer patients in the TAVI-first group ultimately underwent PCI, and life-threatening bleeding occurred at a lower rate with the TAVI-first strategy.
Transcatheter tricuspid valve repair improved heart failure hospitalization and all-cause mortality in patients with severe tricuspid regurgitation. The TRIC-I-HF trial demonstrated a significant benefit in reducing hard clinical outcomes, including quality-of-life improvements and sustained reductions in mortality.
The ACASA-TAVI trial found that non-vitamin K antagonist oral anticoagulants (NOACs) significantly reduced imaging signs of leaflet thrombosis by 45% compared to antiplatelet therapy after TAVI. NOAC monotherapy also demonstrated a comparable safety profile, with lower risk of severe bleeding events.
The TIME-HF trial found that a nurse-led intervention improving guideline-directed medical therapy uptake and clinical outcomes in patients with heart failure in India led to increased days alive and out of hospital and a 22% reduction in deaths at 2 years. This collaborative care model may serve as a blueprint for other settings with ...
A phase IIb trial found that AZD5462, an oral relaxin agonist, improved cardiac function in patients with heart failure, particularly at the lowest dose, with no safety concerns noted. The study suggests that AZD5462 may be a promising addition to existing therapies for heart failure.
A nationwide study found that early initiation of statins after type 2 diabetes diagnosis was associated with a 15% lower relative risk of dementia over 10 years. Statin treatment was also linked to a 10% lower risk of dementia in patients who initiated treatment between one and five years after diagnosis.
The H-HeFT trial found no significant difference in death or heart failure events with hydralazine–isosorbide dinitrate versus placebo in patients with heart failure and reduced ejection fraction. High treatment discontinuation rates emphasize the need for careful evaluation of hydralazine–isosorbide dinitrate's tolerability profile.
A large randomized trial and meta-analysis found no evidence that metformin reduces cardiovascular outcomes in patients with heart failure with reduced ejection fraction and diabetes. Metformin remains beneficial for glucose lowering but lacks cardioprotective benefits.
A virtual e-health system (VIRTUES) has been found to be as safe and effective as standard care for monitoring cardiac implantable electronic devices, with significant cost savings and patient satisfaction. The system uses transmission reports from the patient's device to provide real-time monitoring and communication with the physician.
The AIR-STEMI trial found that functional coronary angiography significantly reduced major cardiovascular events and complications by 38% and 37%, respectively, compared to conventional angiography. The study showed that this approach can improve current care for high-risk patient populations by selecting and treating only clinically i...
A digital strategy identified untreated patients with heart failure and invited them for specialist evaluation, resulting in a more than doubling of guideline-recommended SGLT2 inhibitor therapy. The approach showed promise in increasing timely access to effective treatments for this major public health issue.
A new study confirms the safety of rapid heart attack testing but finds no reduction in emergency department stay length. The 0/1-hour pathway was compared to the standard 0/3-hour pathway and was found to be noninferior in terms of safety.
Remote exercise-based cardiac rehabilitation shows promise as an additional option for patients, but does not replace centre-based rehabilitation. The study found that remotely delivered exercise improved physical capacity and was used by a substantial proportion of patients, despite not increasing overall participation.
A new study found that atorvastatin reduces major cardiovascular events by 30% in people aged 70 and older without known cardiovascular disease, diabetes, or dementia. However, it did not improve disability-free survival. The results inform treatment guidelines for older adults, who are underrepresented in previous trials.
The AMUNDSEN trial found that evolocumab significantly improved LDL-cholesterol goal achievement after a heart attack, but did not show early cardiovascular benefits. Patients who received evolocumab had a higher rate of LDL-C goal attainment compared to standard care.
Pacibekitug, a long-acting monoclonal antibody targeting interleukin-6, produced sustained reductions in inflammatory markers in patients with chronic kidney disease. The treatment also showed dose-dependent effects on other inflammatory markers, such as fibrinogen and lipoprotein(a).
Atrial fibrillation patients with prior intracranial haemorrhage face uncertain stroke prevention strategies. Edoxaban trial findings indicate a need for individualised decision-making, highlighting increased bleeding risk in this population.
A study found that silent atherosclerosis is prevalent in 57.1% of adults, increasing with age and affecting men earlier than women. Conventional risk assessment often misses this disease, highlighting the need for early imaging detection and potential precision medicine approaches.
Atrial fibrillation patients who have had a heart attack may be at increased risk of bleeding if given potent antiplatelet therapy combined with direct oral anticoagulants. The EPIDAURUS trial found no significant benefits regarding cardiovascular events, suggesting these treatments may not be necessary for this patient population.
The PREMIUM trial suggests that dual antiplatelet therapy with a potent P2Y12 receptor inhibitor plus aspirin is recommended for up to 12 months after a STEMI. However, further studies are needed to determine the optimum antiplatelet regimen in patients after a STEMI.
The A-CLOSE trial found that extended dual antiplatelet therapy (DAPT) provides greater protection against cardiovascular events, but clopidogrel monotherapy reduces bleeding risk. Long-term antiplatelet strategies should be tailored to each patient's clinical characteristics.
The LIBREXIA ACS trial found that patients remain at risk of recurrent cardiovascular events after an acute coronary syndrome. No difference was observed in cardiovascular events or bleeding with milvexian compared to placebo, despite expected anticoagulant activity.
The SWITCH SWEDEHEART trial found prasugrel comparable to ticagrelor for major cardiovascular events, but with lower major bleeding risk. Prasugrel reduced major bleeding by 4.2% compared to ticagrelor.
The new ESC Guidelines on cardiac rehabilitation emphasize its benefits for patients with various heart conditions, improving heart health and reducing the risk of cardiac events. The guidelines also highlight the importance of individualized programs, patient-centered care, and cost-effectiveness.
The 2026 ESC Guidelines on heart failure introduce significant changes, including a staging approach and removal of the mildly reduced ejection fraction phenotype. New recommendations focus on prevention, early treatment, and patient education, with updated therapies for specific patient populations.
A universal definition of myocardial infarction has been developed to improve diagnosis and treatment. The new definition considers the underlying cause of the MI and aligns with established approaches to clinical evaluation.
The new guidelines aim to increase kidney function and urine albumin testing in patients with CVD, identifying at-risk patients and prescribing targeted treatments. Early use of RAS inhibitors and SGLT2 inhibitors, alongside statin-based therapy, is particularly important in slowing CKD progression and reducing cardiovascular events.
A randomized trial found that patients with atrial fibrillation at intermediate risk of stroke experienced a 69% lower risk of adverse events with oral anticoagulants compared to no treatment. The study also showed a lower incidence of ischemic stroke with anticoagulant therapy.
The CARDIO-TTRansform trial investigated eplontersen in patients with transthyretin-mediated amyloid cardiomyopathy, but failed to meet its primary endpoint. The study found that eplontersen reduced circulating serum TTR, but had no significant impact on cardiovascular mortality and recurrent cardiovascular events in the overall popula...
A tailored strategy shortened antibiotic duration by two weeks in patients with left-sided infective endocarditis, with no compromise on safety. The study found that rates of primary relapse were low, and most were easily managed with reinitiation of antibiotics.
The ACACIA-HCM trial showed aficamten significantly improves symptom burden and exercise capacity in patients with symptomatic non-obstructive hypertrophic cardiomyopathy. Clinically meaningful improvements were documented for the first time in this relatively common form of inherited heart disease.
ICDs did not improve overall primary endpoint but showed benefit in younger patients (under 70) with a 72% reduction in sudden cardiac death. In contrast, older patients did not derive benefit from ICDs.
A study found that AI analysis of mammograms can identify features indicative of hypertension, ischaemic heart disease, and stroke in women. This could lead to early detection and prevention of cardiovascular diseases in midlife women who undergo routine breast cancer screening.
A meta-analysis of 91,339 trial participants found that patients with higher adherence to antihypertensive medication experienced significant reductions in systolic blood pressure and major cardiovascular disease events. In contrast, patients with lower adherence showed little to no cardiovascular benefit
A new AI-based diagnosis tool can detect hypertension and diabetes from a single facial video, with high accuracy and potentially reaching far more people than traditional screening methods. The algorithm can estimate blood pressure from a facial video alone, without a cuff.
A study found that high blood levels of xylitol were associated with an increased risk of major adverse cardiovascular events. Researchers analyzed data from 17,710 participants and found a dose-dependent relationship between xylitol levels and cardiovascular event rates.