What’s Going to Be Hot at ESC 2026

The European Society of Cardiology (ESC) Congress is rapidly approaching. Held this year in Munich, Germany, from August 28 through 31, the meeting is expected to attract more than 30,000 clinicians, researchers, and journalists eager to hear about the results and trends set to shape cardiology.

I’ll be there on-site alongside TCTMD senior medical journalist L.A. McKeown to cover not only data, but also debates, key themes, and more. Senior Clinical Editor Mamas Mamas, BMBCh, DPhil, is set to explore major trials through numerous Beyond the Data videos as well. Please do reach out if you’d like to share your thoughts or your work, or even just to say hello. All our coverage can be found on TCTMD’s ESC Congress hub.

Video Interview

Cardialogue: ESC Congress 2026 Preview

August 28, 2026

Don’t worry: as busy as we’ll be, we do plan to track down some Bavarian pretzels as big as our heads.

In the latest episode of TCTMD’s Rox Heart Radio podcast, host Roxana Mehran, MD (Icahn School of Medicine at Mount Sinai, New York, NY), got an in-depth preview of what’s to come in Munich from both Tomasz J. Guzik, MD, PhD (Jagiellonian University Medical College, Kraków, Poland), and ESC President Thomas Lüscher, MD (Royal Brompton and Harefield Hospitals, London, England).

“I think it’s very important to emphasize that the program of the ESC is put together by a large group of specialists from different angles and areas of cardiology. We cover practically every corner of our specialty,” said Guzik, who chairs the ESC Congress program committee. He stressed, too, that the meeting is known for its global perspective.

For his part, Lüscher highlighted artificial intelligence (AI) as a prominent theme of the conference.

“AI is everywhere. . . . Future cardiologists will have different skills, and we have to actually think of [upcoming generations] and have training tracks that accommodate these new technologies, critical thinking, knowledge about what has been well validated and developed,” he explained. 

“What we want to show in the Congress is how AI can serve as a copilot,” Guzik commented, adding that “the clinician remains the pilot.”

The Congress’ AI in Practice Track explores how the technology can support healthcare professionals in imaging interpretation, risk stratification, decision-making, and more, while the Digital Cardiology Track encompasses other digital advances, from machine learning to mobile apps, with an eye toward ethical and technical considerations.

This year, the meeting received a record number of submissions for late-breaking sessions, according to an ESC press release. From that abundance, 59 clinical trials were selected for presentation across 12 Hot Line sessions with themes spanning from new drugs and devices to imaging and digital innovations.

On top of this, there will be 30 Late-Breaking Science sessions as well as no fewer than 133 Abstract sessions, 108 Symposiums, 21 Great Debates, and 10 Fireside Chats. Importantly, the Fifth Universal Definition of MI plus three new ESC guidelines—heart failure (HF) management, cardiac rehabilitation, and the dual management of cardiovascular and chronic kidney disease (CKD)—will come out during the meeting. There’s also hands-on learning, ePosters, and more.

The Hot Lines

The Hot Line sessions are likely the most-anticipated aspect of the ESC Congress each year, with attendees watching as closely as they would a Bayern Munich match.

Friday, August 28, kicks off the meeting with Hot Line 1 by covering a wide range of topics. It will include CARDIO-TTRansform, a trial of eplontersen in patients with transthyretin amyloid cardiomyopathy that Ionis Pharmaceuticals and AstraZeneca have already revealed did not meet its primary endpoint—the question, of course, is why. For symptomatic nonobstructive hypertrophic cardiomyopathy, meanwhile, the session features ACACIA-HCM, whose top-line results were positive. Other presentations relate to the SINGLE-AF trial of anticoagulation in atrial fibrillation (AF) patients at intermediate stroke risk, the POET-II trial evaluating tailored-duration antibiotics in infectious endocarditis, and the CMR GUIDE trial looking at how cardiac magnetic resonance can inform management of mild-to-moderate LV dysfunction.

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The next day, Saturday, August 29, features four Hot Line sessions.

In the morning, Hot Line 2 delves into prevention and risk reduction through results from STAREE, which studied statin therapy in elderly patients, and from AMUNDSEN, which tested the impact of evolocumab (Repatha; Amgen) before PCI in acute MI. Other presentations in the session include the TRANQUILITY trial of pacibekitug (Novartis), an investigational monoclonal antibody targeting interleukin-6, in CKD patients with elevated high-sensitivity C-reactive protein; REACT, a study measuring the prevalence of silent atherosclerosis across the adult lifespan; the ENRICH-AF trial of edoxaban in intracranial hemorrhage survivors with AF; and DAN-RSV, a trial studying the bivalent respiratory syncytial virus (RSV) prefusion F vaccine.

In particular, the STAREE trial “will have direct relevance to millions of older adults and their clinicians,” Guzik said in the ESC press release. “[It] addresses a very common dilemma in clinical practice—should we give statins to healthy people aged over 70 years to reduce the risk of cardiovascular events and survival free of dementia?”

Hot Line 3, later in the morning, focuses on post-ACS antithrombotic therapy with data from the LIBREXIA-ACS trial of the oral factor XIa inhibitor milvexian (Bristol Myers Squibb/Janssen), which was halted last year after a preplanned interim analysis suggested the study would not meet its primary endpoint, as well as the PREMIUM trial of aspirin omission at the time of primary PCI for STEMI, the SWITCH SWEDEHEART trial looking at whether it makes sense to switch from ticagrelor to prasugrel in ACS, the A-CLOSE trial pitting clopidogrel monotherapy against extended dual antiplatelet therapy (DAPT) beyond 12 months after high-risk PCI, and the EPIDAURUS trial testing whether the strategy of using a direct oral anticoagulant (DOAC) plus an escalated antiplatelet therapy (either prasugrel or ticagrelor) for 1 month followed by clopidogrel can reduce ischemic events without increasing bleeding in AF patients who’ve undergone PCI for ACS.

LIBREXIA-ACS, with more than 14,000 patients, stands out as a trial worth watching, Guzik said. “For years, the field has awaited evidence [on] whether factor XIa inhibitors can reduce recurrent ischemic events after acute coronary syndromes without the bleeding seen with earlier anticoagulants. This landmark trial could redefine the management of underlying risk after a myocardial infarction.”

Hot Line 4 follows on Saturday afternoon, with the theme of chest pain diagnostics. PRESC1SE-MI is looking at the safety and efficacy of the ESC 0/1-hour algorithm, while an individual patient-level meta-analysis is comparing that algorithm to standard care pathways in MI. AIR-STEMI is set to shed light on angiography-derived fractional flow reserve in STEMI and TARGET-CTCA will explore how troponin levels in acute chest pain might inspire effective use of CT coronary angiography.

Rounding out the jam-packed day is Hot Line 5. That session devoted to digital health and remote care includes the EMAIL-HF trial, which is testing a digital strategy for implementation of SGLT2 inhibitors in heart failure, as well as ADHERE-ASCVD, assessing adaptive digital outreach to promote statin adherence. Remote Exercise SWEDEHEART is a cluster-randomized crossover trial of telemedicine for cardiac rehabilitation, and the VIRTUES ICD and VIRTUES PM studies are evaluating digital platforms for ICDs and pacemakers.

* * *

Sunday, August 30, begins with Hot Line 6. It features several presentations related to HF pharmacotherapy. The H-HeFT and Met-HeFT trials—collectively known as DANHEART—are testing hydralazine in combination with either isosorbide dinitrate or metformin versus placebo, respectively, in patients who have heart failure with reduced ejection fraction; each will be accompanied by a related meta-analysis. The phase IIb LUMINARA trial is evaluating AZD5462 (AstraZeneca), a once-daily oral relaxin agonist, in chronic HF. The PADN-PH-LHD trial is taking a device-based approach by looking at pulmonary artery denervation for pulmonary hypertension due to left HF, and TIME-HF digs into the human side of management by looking at team-based collaborative care in HF.

Hot Line 7, with its focus on structural heart disease, fills out the morning. In this session, POPular ACE TAVI compares routine versus selective use of protamine to reduce bleeding after transcatheter aortic valve replacement, while ACASA-TAVI and NOTION-4 relate to antithrombotic therapy and durability. A fourth study, called TAVI PCI, is looking at how best to time treatment for patients who need both interventions. And finally, the investigator-initiated TRIC-I-HF trial is examining strategies for tricuspid intervention in heart failure.

After lunch, Hot Line 8 takes on AF management. Among its offerings are the AFFIRMO trial of an integrated approach in older adults who are frail and have multiple comorbidities for which they are receiving medical therapy. The NEXAF trial looks at the impact of reduced exercise intensity among endurance athletes with nonpermanent AF. On the device front, PVI-SHAM-AF is comparing pulmonary vein isolation versus a sham control for symptom relief and IDEAL-AF is investigating individually tailored low-voltage ablation of fibrotic areas in persistent AF.

Later that afternoon, Hot Line 9 covers a host of conditions including hypertension, lipids, and cardiometabolic disease. It’s an enticing selection: SHASTA-3/4 focuses on plozasiran (Arrowhead Pharmaceuticals), a small-interfering RNA (siRNA) that degrades mRNA coding for APOC3, in severe hyperglyceridemia; the China Rural Hypertension Control Project (CRHCP) aims to test the effectiveness of a village doctor-led intensive blood pressure intervention; and ECLIPSE-CKD, also conducted in China, looks at the potential for a salt substitute in CKD. The session will also include a meta-analysis of BP-lowering treatment across the spectrum of CV risk.

* * *

Monday, August 31, draws the 2026 ESC Congress to a close with three Hot Line sessions.

The first, Hot Line 10, is devoted to arrhythmia and device therapy. It’s trials include ASPIRED, looking at ambulatory ECG versus standard monitoring in acute unexplained syncope, as well as the DANISH-CRT trial of targeted LV lead placement in HF patients with prolonged QRS and SyncAV PMT, a postmarket study of dynamic AV optimization in CRT. Syncope-Stopper compares up-front pacing versus standard care in high-risk unexplained syncope, while His-Alternative II compares His-bundle versus biventricular pacing in HF.

Up next is Hot Line 11, which covers a lot of ground with EVAOLD, a study of reperfusion strategies in elderly patients; ISOLEDS, a trial of IVUS versus OCT guidance for PCI of distal left main bifurcation lesions; CorCal, comparing coronary artery calcium scoring to the pooled cohort equations in primary prevention; and CoCAP, looking into the effect of DAPT versus aspirin monotherapy on graft patency after CABG in ACS patients.

Last but not least is Hot Line 12, sure to draw a diverse audience with its broad range of topics. For out-of-hospital cardiac arrest (OHCA), the DISCO trial is evaluating the potential for acute coronary angiography in resuscitated patients without ST-elevation and the HeartRunner Trial is looking at survival after community first responder activation. Additionally, there’s a study on coronary angiography’s role after OHCA without ST-elevation. PRAGUE-26, on the other hand, assesses catheter-directed thrombolysis for pulmonary embolism, while LACCS-2 zeros in on left atrial appendage closure among patients undergoing cardiac surgery.