World’s biggest cardiology congress comes to London

The world's biggest cardiology congress kicks off in London on Saturday, with academics, heart specialists and pharma companies unveiling the latest insights into one of the world's biggest killers.

The European Society of Cardiology (ESC) congress is also Europe's biggest medical conference, with up to 35,000 delegates from around the world expected to attend the five-day meeting.

Sustained success in cutting premature deaths from heart disease in the last 20 years or so has meant cancer has overtaken cardiovascular disease (CVD) as the biggest health concern in the public and media.

However heart disease is still a huge killer, accounting for around 47 per cent of deaths in Europe – and smoking, high blood pressure, diabetes and physical inactivity are fuelling the problem.

This year's congress 'spotlight' is the environment and the heart, looking at how factors such as air pollution can have a major effect on heart disease.

Another fact is that cardiovascular disease remains the biggest killer of women in Europe, and this will be one of key themes for the congress.

On Tuesday, a special session entitled 'The Heart of a Woman' brings together three new studies on CVD incidence and cardiac care in women. One study is expected to show that women are less likely to survive than men if they have an out-of-hospital heart attack, and are also less likely to receive percutaneous coronary intervention (PCI) treatment to open up blocked arteries.

Speaking at the launch press conference, longstanding ESC leader Professor Keith Fox said these studies would help address wider ignorance of CVD being the biggest killer in women in Europe.

"Not only do women not know this, but actually not all doctors know this," he stated.

Professor Fausto Pinto, the president of the ESC also highlighted the ongoing causes of CVD in men and women, including smoking, high blood pressure and diabetes.

He pointed to a huge increase in the number of diabetes cases, up 50 per cent in many countries in Europe over the last decade.

He said health systems had been "very successful in treating the disease, but not so good at preventing the disease."

On the growing problem of diabetes, he added: "We are dealing with a problem that needs to be faced in multiple ways, and by multiple specialists."

Speaking from a UK perspective was Professor Huon Gray, national clinical director for cardiac care, NHS England, and consultant cardiologist, University Hospital of Southampton.

He confirmed that falling rates of premature deaths had taken away the focus from CVD, but said 200,000 people were still dying from the condition in the UK.

He also agreed that prevention was now a priority, with an NHS Diabetes Prevention Programme launched earlier this year, with seven 'demonstrator' regions piloting the approach.

Professor Geneviève Derumeaux, the chair of this year's congress, highlighted a number of key sessions, including a talk by Nobel Laureate Elizabeth Blackburn on how premature ageing and the role of telomerase can cause CVD.

Key drug news

The biggest buzz at last year's ESC was around Novartis' heart failure drug valsartan/sacubitril – which has now been approved as Entresto in the US, and is expected to gain European approval shortly. Data from its pivotal PARADIGM-HF trial shows it improved overall survival by 16 per cent compared to enalapril, making it a major step forward in treating the condition. Heart failure affects around 23 million people worldwide, and analysts think this huge market means the drug could reach peak annual sales of $10 billion.

Further data from PARADIGM-HF will be presented by lead investigator Professor John McMurray, and published in the New England Journal of Medicine (NEJM).

Another exciting development is the arrival of two new PCSK9 inhibitor drugs for high cholesterol, Amgen's Repatha, now approved in Europe, and Sanofi's Praluent, expected to follow shortly. Lots of sessions will examine the new drugs, which are likely to be among the biggest talking points at the conference – including their high cost.

Other key studies to be published by the NEJM include two major trials of dual antiplatelet therapy (DAPT and PEGASUS), and research into whether a Mediterranean diet can help primary prevention of heart disease (PREDIMED).

A range of NEJM-published studies on rival novel anticoagulants, Boehringer Ingelheim's Pradaxa, Bayer's Xarelto and Pfizer/Bristol-Myers Squibb's Eliquis in atrial fibrillation will also be presented.

As with all congresses, some presentations will focus on failed drugs. ESC will hear about Mydicar, an innovative gene therapy for heart failure which was being developed by US biotech Celladon. Results published in April found the drug failed its pivotal trials, development has now been discontinued, and the company now looks set to be sold or merged.