The most anticipated trials at ESC 2025
The European Society of Cardiology (ESC) 2025 congress is hosting 38 session that will showcase the latest cardiac science and showcase the findings from recent landmark clinical trials. This year's congress is Aug. 29 to Sept. 1 in Madrid, Spain.
Late-breaking science will be presented in 10 Hot Line sessions and 28 late-breaking science sessions at ESC. Professor Tomasz Guzik, chair of the ESC Congress Program Committee, offered his insights as to which trials he feels will be among the most impactful at this year's meeting. He is the chair of cardiovascular medicine at the University of Edinburgh, Scotland, and a professor of medicine, Jagiellonian Iniversity, Krakow, Poland.
“Hot Line sessions at ESC Congress reveal long-awaited answers to major clinical questions, often debated for years. These sessions are built through rigorously selected, late-breaking clinical trials showcasing new treatments, breakthrough procedures, and head-to-head comparisons of new and established treatments," Guzik explained in a statement.
Several late-breaking trials will look at long-used cardiovascular drug therapies to determine if it may be time to consider guideline changes for newer treatments.
“With improved outcomes of our treatments, it’s time to reassess long-term therapies. REBOOT-CNIC and BETAMI-DANBLOCK examine whether long-term beta-blockers are still needed in myocardial infarction, especially if ejection fraction remains preserved, potentially reducing the drug burden and costs for millions. Similarly, antiplatelet and anticoagulation trials like NEO-MINDSET, TARGET FIRST, DUAL-ACS, and ALONE-AF test earlier withdrawal of aspirin or oral anticoagulants to reduce bleeding risk and simplify treatment,” Guzik explained.
This year’s congress is focusing on global health issues, and some of the late-breaking trials reflect on major unmet needs in global cardiovascular care. The PARACHUTE-HF trial offers new information on chronic Chagas cardiomyopathy, which impacts 6-7 million patients in Latin America. This is becoming a bigger issue outside of the region due to increased migration of infected patients.
“It tests sacubitril/valsartan vs. enalapril, aiming to deliver the first mortality-based, guideline-level evidence for this neglected condition,” Guzik explained.
Hypertension is one of the leading global causes of death, and two key trials will be presented on this in the Hot Line 4 session. The BaxHTN trial looks at use of a new aldosterone synthase enzyme inhibitor, and KARDIA-3 looks at use of zilebesiran, a twice-yearly siRNA therapy. Guzik said siRNA could be a game-changer for long-term blood pressure control and treatment adherence.
The Hot Line trial sessions also provide cardiologists with some practice-changing insights that may have a direct impact on everyday patient care.
In heart failure, DAPA ACT HF-TIMI 68 explores starting SGLT2 inhibitors during hospitalization for acute heart failure. Guzik said this is an approach that could benefit more than 11 million patients globally. Another trial, VICTOR and VICTORIA looks at expanding the role of vericiguat as a simple, once-daily option for chronic heart failure. Both of these trials will be presented in the Hot Line 2 session.
“Two key phase 3 trials, ODYSSEY-HCM and MAPLE-HCM may transform hypertrophic cardiomyopathy care by establishing oral myosin inhibitors, mavacamten and aficamten, respectively as effective alternatives to invasive strategies,“ Professor Guzik said. These trials also will be presented during the Hot Line 2 session.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]