To Face Scrutiny at ESC: Statins for the Elderly, New Heart Attack Therapies

The European Society of Cardiology (ESC) conference, running from August 28 to August 31 in Munich, Germany, will highlight several groundbreaking trials and studies in cardiovascular medicine. One of the most anticipated is the STAREE trial, which will determine whether primary prevention statins benefit survival and cardiovascular outcomes in individuals aged 70 or older.

With nearly 10,000 participants, STAREE aims to provide clarity on the use of statins in healthy older adults without a history of atherosclerotic cardiovascular disease.

Additionally, STAREE addresses the ongoing debate surrounding the use of statins in this population, as they have been linked to potential side effects such as muscle pain and fatigue. The trial's findings will have direct implications for millions of older adults and their clinicians.

Other major presentations include the LIBREXIA ACS study, which will report on the use of milvexian, a next-generation factor XIa inhibitor, in acute coronary syndrome patients. Milvexian, known for its potential safety advantages over current oral anticoagulants, was prematurely halted due to its failure in reducing major adverse cardiovascular events among recent heart attack survivors.

The conference will also feature studies on acute myocardial infarction (MI), such as the AMUNDSEN trial, which examines the effectiveness of PCSK9 inhibitor evolocumab (Repatha) before percutaneous coronary intervention for acute MI, and the PRESC1SE-MI trial, analyzing the utility of the ESC's rapid 0/1-hour troponin algorithm for MI diagnosis in emergency departments.

Furthermore, the ESC will showcase advancements in atrial fibrillation (AFib) management, with presentations on direct oral anticoagulant therapy for AFib patients with intermediate stroke risk (SINGLE-AF), pulmonary vein isolation for AFib (PVI-SHAM-AF), and a 12-month exercise routine for paroxysmal or persistent AFib (NEXAF).

Finally, the conference will introduce the Fifth Universal Definition of Myocardial Infarction and present three new guidelines: one for heart failure management, one for cardiac rehabilitation, and one for the dual management of cardiovascular and chronic kidney disease.