What's Going to Be Hot at the ESC 2012 Congress

Shelley Wood

August 21, 2012

August 21, 2012 (Munich, Germany) — This year's European Society of Cardiology (ESC) 2012 Congress is back in Bavaria after a four-year absence. Organizers of the meeting say the line-up of hot-line trials offers a mix of new treatments as well as several seeking to prove once and for all whether certain treatments, used for years, are really the best approach.

In all, this year's program includes 18 hot lines, grouped in three sessions over three days. Among the studies garnering the biggest buzz in the lead-up to the ESC meeting is TRILOGY-ACS, a comparison of prasugrel and clopidogrel in the setting of medically managed unstable angina/NSTEMI.

Congress program chair Dr Michael Böhm (Saarland University Hospital, Homburg/Saar, Germany), also pointed to the long-awaited details from the ALTITUDE trial of aliskiren (Rasilez/Tekturna, Novartis) in patients with type 2 diabetes and renal impairment. As reported by heartwire , the trial's data and safety monitoring board halted the study in December 2011 after seeing an increase in adverse events and no apparent benefits among patients randomized to the direct renin inhibitor.

Böhm also singled out the IABP-SHOCK II trial as "one of the most important trials of the meeting," since it is tackling a practice used for years in many countries--intra-aortic balloon counterpulsation in AMI complicated by shock. "Its use is very widespread, but registries have shown that there is the potential for it to be completely ineffective."

Lacking, at least in the line-up of hot lines, are experimental drugs, the sole exception being Sunday's PARAMOUNT trial, looking at LCZ696 (Novartis), a first-in-class angiotensin receptor neprilysin inhibitor in patients with heart failure and preserved ejection fraction.

But other hot topics also make the list, including, on Monday, the German Aortic Valve Registry (GARY)--not a randomized study, but using matched controls to examine in-hospital outcomes with the new transcatheter-valves in the country with the biggest implantation rate of these devices worldwide.

Another less invasive approach to valve disease, the MitraClip (Abbott), also appears in new registry results from ACCESS EUROPE.

Two imaging studies also made the cut for hot lines in this year's program: FAME II, addressing the role of fractional-flow-reserve–guided PCI vs optimal medical treatment alone for stable CAD, and CORE 320, investigating the diagnostic performance of 320-row-detector computed tomography (CT) plus myocardial perfusion imaging.

And one of the showcase studies from last year's meeting, PURE, makes a reappearance in this year's meeting: this time around, investigators are unveiling data on CVD risk factors globally, stratified by urbanization, gender, and economic status.

Familiar Faces

As with last year's meeting, ESC 2012 is offering a Clinical Trial and Registry Updates session, once again focusing on new data from some of the biggest trials of recent years, including ATLAS ACS 2, REVERSE, TRA 2ºP, RE-LY, and ARISTOTLE.

According to Böhm, these may be analyses of new questions using the trials' data sets, rather than longer follow-up data from the original trial design.

Böhm also pointed to several sessions on renal denervation, which he called "a very hot topic." Renal-denervation devices for the treatment of resistant hypertension are approved in Europe, but not in the US or Canada. In this field, too, Germany has one of the largest physician experiences with the procedure, Böhm said. Among the oral and poster sessions on this topic are registry series assessing the impact of the new treatment on blood pressure but also end points such as arterial stiffness as well as physical and mental health.

Meeting in Munich

According to Böhm, premeeting registration for this year's congress is slightly lower than the numbers seen for Paris last year, but he expects those to rise substantially with on-site registration. The conference received over 9600 abstracts, 4200 of which were accepted for this year's program.

And Munich, Böhm noted, is a great city for a meeting, with an easy-to-reach venue. The congress center, Messe München is just 10 km outside of Munich's main station and has its own subway stop (Messestadt West)--a 20-minute journey on the U-Bahn (U2) subway line. The ESC is offering a special congress rate of €20 on a five-day public transport pass, for sale at the convention center.

News breaks on theheart.org throughout the day: visit at any time to read or watch our in-depth coverage of trials and issues. You can also follow the heartwire team on Twitter for news and commentary on the meeting, stay up to date using our mobile edition or iPhone app , and join our Facebook page, for a "backstage" look at how our reporters and the rest of theheart.org team bring you the news.


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