ESC Congress 2017 In Review – Focus on CAD&ACS - 2

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

Marc P. Bonaca, MD, MPH

Jacob A. Udell, MD, MPH

Nihar R. Desai, MD, MPH

Matthew Cavender, MD, MPH

Erin A. Bohula May, MD, PhD

Carlos Aguiar, MD, FESC

Jan Steffel, MD, FESC, FHRS

Staff Physician Cardiovascular Division
Brigham and Women's Hospital
Associate Professor in Medicine
Harvard Medical School
Boston, Massachusetts, USA

Associate Physician Cardiovascular Division
Yale-New Haven Hospital
Assistant Professor Medicine
Yale School of Medicine
New Haven, Connecticut, USA

Giulia Magnani, MD, PhD

Consultant, Department of Cardiology
University Hospital Zurich
Zurich, Switzerland

2

October 2017

Physician Vascular Section
Cardiovascular Division
Brigham and Women's Hospital
Assistant Professor in Medicine
Harvard Medical School
Boston, Massachusetts, USA

Assistant Professor of Medicine
University of North Carolina
Chapel Hill, North Carolina, USA

Department of Cardiology
Hospital de Santa Cruz
Carnaxide, Portugal

Physician Cardiovascular Division
Women's College Hospital
Toronto General Hospital
Assistant Professor of Medicine
University of Toronto
Toronto, Ontario, Canada

Associate Physician Cardiovascular Division
Brigham and Women's Hospital
Instructor in Medicine
Harvard Medical School
Boston, Massachusetts, USA

Co-Head, Division of Electrophysiology and
Devices
Senior Consultant, Department of Cardiology
University Heart Center Zurich
University Hospital Zurich
Zurich, Switzerland

www.escardio.org/ESCcongressinreview
http://www.escardio.org/ESCcongressinreview
Table of Contents for the Digital Edition of ESC Congress 2017 In Review – Focus on CAD&ACS
