My top 10 learning points from the #ESCCongress

A thread for cardiologists/general physicians

1) Post acute MI, transfuse if ≤8g/dL

Evidence: REALITY trial- not yet published – summary reported https://www.acc.org/latest-in-cardiology/clinical-trials/2020/08/29/13/09/reality

1/n

2) SGLT2i in addition to standard HF treatment significantly CV death, including in non-diabetic pts

Evidence: EMPEROR-Reduced ( https://www.nejm.org/doi/full/10.1056/NEJMoa2022190)
& metanalysis of DAPA-HF and EMPEROR-Reduced ( https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31824-9/fulltext)

#ESCCongress
2/n

3) Colchicine 0.5mg od in pts with chronic coronary diseaseCV death/MI/CVA

Evidence: LoDoCo 2 - https://www.nejm.org/doi/full/10.1056/NEJMoa2021372

#ESCCongress

3/n

4) Dapagliflozin in pts with CKD, with or without T2DM, significantly risk of kidney failure, CV death and HF hospitalisation

Evidence: DAPA CKD – not yet published - https://www.escardio.org/The-ESC/Press-Office/Press-releases/DAPA

#ESCCongress

4/n

5) Digoxin could be considered as a first-line approach for rate control in older adults with AF

Evidence: RATE-AF – not yet published - https://cardiacrhythmnews.com/esc-2020-congress-digoxin-found-to-be-favourable-in-rate-control-for-permanent-af-patients/

#ESCCongress

5/n

6) There is a new treatment option for HOCM – mavacamten

Evidence: EXPLORER-HCM - https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31792-X/fulltext

#ESCCongress

6/n

7) No need to stop ACEi/ARB in COVID pts

Evidence: BRACE CORONA - not yet published - https://www.escardio.org/The-ESC/Press-Office/Press-releases/LOPES

#ESCCongress

7/n

8) Early rhythm control decreases risk of adverse cardiovascular outcomes in AF

Evidence: EAST AFNET 4 https://www.nejm.org/doi/full/10.1056/NEJMoa2019422

#ESCCongress

8/n

9)Post TAVI, aspirin alone is a better strategy than aspirin and clopidogrel

Evidence: POPULAR TAVI https://www.nejm.org/doi/full/10.1056/NEJMoa2017815

#ESCCongress

9/n

10) Either the sPESI or the HESTIA score can be used to identify ~ a third of pts with PE who can be discharged early and treated at home

Evidence: HOME PE - not yet published - https://www.escardio.org/The-ESC/Press-Office/Press-releases/Trial-clarifies-which-patients-with-acute-pulmonary-embolism-can-be-managed-at-home

#ESCCongress

10/10