ESC 2019 key messages:
1- Aspirin in primary prevention is not recommended in patients with DM at moderate CV risk and may be considered in patients with DM at very high risk in the absence of clear contraindications.
2- clopidogrel is increasingly losing its interest in ACS but still holding in stable CAD
3- Sacubitril/Valsartan “Enteresto” has no role in HF preserved EF (PARAGON -HF trial)
4-There is no role for early intensive and sustained vasodilation in management of acute HF (GALACTIC trial)
5-SGLT2 inhibitors reduces death and hospitalisation in patients with heart failure and reduced ejection fraction with and without DM( DAPA-HF trial )
6- SGLT2 inhibitors stole the show from metformin in patients with DM and established CVD or at high and very high CVD risk.
7- In the absence of multi vessel disease,Left main coronary artery (LMCA) PCI in patients with or without DM is as good as surgery.
Among patients with complex coronary artery disease (CAD) who required de novo revascularization, those with three-vessel disease had better 10-year survival after coronary artery bypass grafting (CABG) than after percutaneous coronary intervention(PCI).
SYNTAXES trial
8- Rivaoxaban and Edoxapan are the OAC of choice in management of PE in cancer patients.
In patients with PE eligible for NOACs, a NOAC is recommended in preference to a VKA.
9- “Chronic coronary syndrome” (CCS) replaces “Stable CHD” and recognizes CAD as a “dynamic process” of atherosclerosis and altered arterial function “that can be modified by lifestyle, pharmacological therapies, and revascularization, which result in disease stabilization or regression.
10- In the managment of dyslipidaemias,The rule now is " lower is better” and a LDL <55 target should be considered in very high risk patients.