ESC Congress 2022 August 26-29 Day 1 Quick Updates

An annual dosage of siRNA vaccine presents a viable method for lowering LDL, reducing cardiovascular events, and decreasing the progression of atherosclerosis.
Starting at age 55, twice-yearly siRNA treatment reduces LDL by 52%.
Injectables ensures compliance.

Inclisiran-the first-in-class siRNA is EU and FDA approved for LDL lowering in two doses per year.
Gene editing therapy inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9) synthesis by RNA interference.
Blocking PCSK9 synthesis reduces LDL levels and is one of the most sought after novel approaches investigated by pharmaceutical firms.

According to evidence, the combination of ezetimibe, bempedoic acid, and inclisiran is more effective in reducing LDL-C levels.
At their maximum dose, statins have several drawbacks.
Novel agents, such as the CETP inhibitor Obicetrapib, as well as oral PCSK9 modulators, have showed encouraging outcomes

Genetic testing and genetic should be undertaken in patients with clinical suspicion or clinical diagnosis of catecholaminergic polymorphic ventricular tachycardia.
It is advised that public access defibrillation be made available in areas where cardiac arrest is more prone to occur.
Promoting community training in basic life support is advised to boost bystander CPR and AED use.

Features 272 new guidelines for the definition, diagnosis, treatment, and prevention of cancer therapy-related CV toxicities, as well as the management of CV induced directly or indirectly by cancer.
Echocardiography is suggested as the first-line modality for assessing heart function in cancer patients, with csrdiovascular magnetic resonance being evaluated when echocardiography is unavailable or undiagnostic.
Cancer and CV symptom burden, cancer prognosis, cancer therapies needing alternative solutions, drug-drug interactions, and patient preferences should all be considered when making treatment decisions.

It is suggested for all individuals with suspected pulmonary hypertension to get transthoracic echocardiography guidance for right heart imaging (TTE).
Right heart catheterization is recommended to confirm the diagnosis of pulmonary hypertension (particularly PAH or CTEPH) and to support treatment options.
Initial combination treatment with PDE5i and an endothelin receptor antagonist is advised in individuals with IPAH/HPAH/DPAH who are at low or intermediate risk of mortality.

Patients with CVD, CV risk factors (including age >65 years), or symptoms indicative of CVD should utilize hs-cTN or hs-CTN I before immediate or high risk NCS, as well as at 24 and 48 hours thereafter.
Individuals with CVD, CV risk factors (including age >65 years), or symptoms indicative of CVD should have BNP or NT-proBNP measured before intermediate and high risk NCS.
It is not advisable to start beta-blockers before non-cardiac surgery on a regular basis.

TIME study is pragmatic, decentralised, large study comparing the effects of evening vs. morning dosage on CV outcomes.
Allocating antihypertensive medicine to the evening dose did not enhance the primary endpoint.
Patients can be instructed that they can take their antihypertensive medicine in the morning or evening because the timing has no effect on cardiovascular outcomes.

A polypill therapy regimen comprising aspirin, atorvastatin, and ramipril resulted in fewer recurrent cardiovascular events after myocardial infarction, likely due to greater adherence.
The polypill method is safe to use, with no differences in adverse events between groups.
Using a cardiovascular polypill as a substitution approach might be an important component of the global strategy to improve secondary prevention.

Sacubitril/valsartan did not affect cognitive function assessed during a comprehensive battery of tests in an adequately powered, blinded, 3-year randomised trial
Beta-amyloid deposition in the brain was less in patients treated with Sacubitril/valsartan compared to valsartan.
There was no evidence of an increased risk of cognitive impairment by neprilysin inhibition related to beta-amyloid accumulation in the brains of individuals with HFmrEF/HFpEF.

The FDA has approved an innovative treatment for heart failure called Baroreceptor Stimulation, which relieves symptoms of HFrEF.
Baroflex Activation Therapy (BAT) reduces sympathetic activity while improving parasympathetic activity.
In BEAT HF trial, the BAT improved the quality of life and NT-pro-BNP considerably.

Mavacamten is the first in class for inhibiting cardiac myosin and lowering profibrotic gene expression.
Mavacamten is authorized by the FDA in the United States under the REMS program; nevertheless, medication interactions must be avoided.
The REDHOOD study revealed that Aficatem is a next-generation agent that reduces hypercontractility

NOACs are an effective therapy option for stroke in individuals with NVAF, diabetes, and compromised renal function.
NOACs are recommended for the treatment of cancer associated thrombosis by clinical recommendations like as ISTH, ASCO, ESC, NCCN, and ITAC.
When compared to LMWH, patients taking a NOAC have greater effectiveness and a comparable overall major bleeding risk.