ESC Congress 2026: A Hot Line Preview from Munich

The European Society of Cardiology Congress returns August 28–31, this year in Munich, and it’s shaping up to be one of the most data-dense meetings in recent memory. More than 30,000 clinicians, researchers, and journalists are expected in the city for four days that include 12 Hot Line sessions covering 59 late-breaking trials, plus three new guidelines and an updated universal definition of MI.

AI as the headline theme

Artificial intelligence runs through much of this year’s programming. ESC leadership has framed it as central to how the next generation of cardiologists will need to train — not just reading images faster, but understanding what’s actually been validated. The guiding philosophy: AI as copilot, clinician as pilot. That shows up structurally in a dedicated AI in Practice track (imaging interpretation, risk stratification, decision support) alongside a Digital Cardiology track covering machine learning and mobile health tools.

The guidelines to watch

Three new ESC guidelines drop during the meeting — heart failure management, cardiac rehabilitation, and combined cardiovascular-CKD management — alongside the Fifth Universal Definition of Myocardial Infarction. Any one of these alone would typically anchor a congress.

Friday, August 28 — Hot Line 1

Cardiomyopathy, endocarditis, anticoagulation, and imaging-guided device therapy open the programme.

• CARDIO-TTRansform — eplontersen in transthyretin amyloid cardiomyopathy. Already known to have missed its primary endpoint; the question is why.
• ACACIA-HCM — aficamten in symptomatic nonobstructive HCM, a population with no approved disease-modifying therapy. Topline results were positive.
• SINGLE-AF — anticoagulation strategy in AF patients at intermediate stroke risk.
• POET-II — tailored-duration antibiotic treatment for infective endocarditis.
• CMR GUIDE — cardiac MRI-guided ICD decisions in mild-to-moderate LV systolic dysfunction.

Saturday, August 29 — Hot Lines 2 through 5

Hot Line 2 — prevention and risk reduction

• STAREE — statins in patients over 70. Addresses whether healthy older adults should be started on a statin for CV and dementia-free survival benefit.
• AMUNDSEN — evolocumab given before PCI in acute MI.
• TRANQUILITY — pacibekitug, an IL-6-targeting monoclonal antibody, in CKD patients with elevated hs-CRP.
• REACT — prevalence of silent atherosclerosis across the adult lifespan.
• ENRICH-AF — edoxaban vs non-anticoagulant therapy in AF patients who survived an intracranial hemorrhage.
• DAN-RSV — bivalent RSV prefusion F vaccine for preventing cardiorespiratory hospitalizations.

Hot Line 3 — post-ACS antithrombotic therapy

• LIBREXIA-ACS — milvexian, an oral factor XIa inhibitor, in over 14,000 patients after ACS. One of the most closely watched antithrombotic programs in cardiology right now.
• PREMIUM — aspirin omission at the time of primary PCI for STEMI.
• SWITCH SWEDEHEART — switching from ticagrelor to prasugrel in ACS.
• A-CLOSE — clopidogrel monotherapy vs extended DAPT beyond 12 months after high-risk PCI.
• EPIDAURUS — one month of escalated antiplatelet therapy plus a DOAC, then clopidogrel, in AF patients after PCI for ACS.

Hot Line 4 — chest pain diagnostics

• PRESC1SE-MI — safety and efficacy of the ESC 0/1-hour troponin algorithm.
• 0/1-hour algorithm vs standard care pathways — individual patient-level meta-analysis.
• AIR-STEMI — angiography-derived fractional flow reserve in STEMI.
• TARGET-CTCA — using troponin levels in acute chest pain to guide CT coronary angiography use.

Hot Line 5 — digital health and remote care

• EMAIL-HF — digital strategy for SGLT2 inhibitor implementation in heart failure.
• ADHERE-ASCVD — adaptive digital outreach to promote statin adherence.
• Remote Exercise SWEDEHEART — cluster-randomized crossover trial of telemedicine for cardiac rehab.
• VIRTUES ICD and VIRTUES PM — digital platforms for remote ICD and pacemaker monitoring.

Sunday, August 30 — Hot Lines 6 through 9

Hot Line 6 — heart failure pharmacotherapy

• H-HeFT / Met-HeFT (“DANHEART”) — hydralazine combined with isosorbide dinitrate or metformin, respectively, vs placebo in HFrEF; each paired with a related meta-analysis.
• LUMINARA — AZD5462, a once-daily oral relaxin agonist, in chronic HF.
• PADN-PH-LHD — pulmonary artery denervation for pulmonary hypertension due to left heart failure.
• TIME-HF — team-based collaborative care model in HF.

Hot Line 7 — structural heart disease

• POPular ACE TAVI — routine vs selective protamine to reduce bleeding after TAVI.
• TAVI PCI — timing strategy for patients needing both TAVI and PCI.
• TRIC-I-HF — transcatheter tricuspid intervention strategies in heart failure with severe TR.
• ACASA-TAVI — antithrombotic therapy after TAVI.
• NOTION-4 — subclinical leaflet thrombosis after TAVI.

Hot Line 8 — AF management

• AFFIRMO — integrated care approach in frail, multimorbid older AF patients.
• PVI-SHAM-AF — pulmonary vein isolation vs a sham control for symptom relief.
• NEXAF — reduced exercise intensity among endurance athletes with nonpermanent AF.
• IDEAL-AF — individually tailored low-voltage ablation of fibrotic areas in persistent AF.

Hot Line 9 — hypertension, lipids, cardiometabolic disease

• SHASTA-3/4 — plozasiran, an siRNA degrading mRNA coding for APOC3, in severe hypertriglyceridemia.
• China Rural Hypertension Control Project (CRHCP) — village doctor-led intensive blood pressure intervention.
• ECLIPSE-CKD — salt substitute in CKD, also conducted in China.
• A meta-analysis of BP-lowering treatment across the spectrum of CV risk rounds out the session.

Monday, August 31 — Hot Lines 10 through 12

Hot Line 10 — arrhythmia and device therapy

• ASPIRED — ambulatory ECG vs standard monitoring in acute unexplained syncope.
• DANISH-CRT — targeted LV lead placement in HF patients with prolonged QRS.
• SyncAV PMT — postmarket study of dynamic AV optimization in CRT.
• Syncope-Stopper — up-front pacing vs standard care in high-risk unexplained syncope.
• His-Alternative II — His-bundle vs biventricular pacing in HF.

Hot Line 11

• EVAOLD — reperfusion strategies in elderly patients.
• ISOLEDS — IVUS vs OCT guidance for PCI of distal left main bifurcation lesions.
• CorCal — coronary artery calcium scoring vs pooled cohort equations in primary prevention.
• CoCAP — DAPT vs aspirin monotherapy on graft patency after CABG in ACS patients.

Hot Line 12

• DISCO — acute coronary angiography in resuscitated OHCA patients without ST-elevation.
• HeartRunner Trial — survival after community first-responder activation in OHCA.
• A related study on coronary angiography’s role after OHCA without ST-elevation.
• PRAGUE-26 — catheter-directed thrombolysis for pulmonary embolism.
• LACCS-2 — left atrial appendage closure among patients undergoing cardiac surgery.

Bottom line

Between LIBREXIA-ACS’s scale, STAREE’s implications for statin use in the elderly, and three fresh guideline documents landing mid-congress, this is a meeting where the practical takeaways will likely outlast the headlines. Worth blocking calendar time for the Hot Line replays if you can’t watch live.