JACC Journals will be simultaneously publishing a plethora of science that will be presented during ESC Congress 2025 in Madrid, Spain. The following are a snapshot of the e-posters and oral abstracts:

JACC
A new meta-analysis from Mattia Galli, MD, PhD, et al., of 21 trials using eight different GLP1-RAs and with nearly 100,000 patients found "conclusive high-certainty evidence" that, vs. controls, the drug reduced all-cause death, cardiovascular death and major adverse cardiovascular events, with a number-needed-to-treat of 121, 170 and 66, respectively, across a diverse population, including those with established cardiovascular disease or at high risk. This remained consistent across patient subgroups, including with or without diabetes, obesity, chronic kidney disease or heart failure. Additionally, GLP1-RAs reduced severe adverse events, myocardial infarction (MI), acute kidney failure, heart failure (HF) and infections, but increased the risk of gastrointestinal and gallbladder disorders.

A prespecified subgroup analysis of EPIC-CAD with 626 patients with high-risk atrial fibrillation (AFib) and stable coronary artery disease who underwent PCI found that at 12 months edoxaban monotherapy, vs. dual-antithrombotic therapy, significantly reduced the incidence of the primary outcome of net adverse events (composite of all-cause death, MI, stroke, systemic embolism, unplanned revascularization or major or clinically relevant nonmajor bleeding) regardless of PCI complexity (6.3% vs. 16.5%). Seong-Bong Wee, MD, et al., write this was primarily driven by a reduction in major or clinically relevant nonmajor bleeding.

A EUROMACS registry analysis of left ventricular assist device (LVAD) carriers found a significantly lower rate of hemocompatibility-related adverse events (HRAEs) among the 2,232 patients with a HeartMate 3 device compared with the 2,088 patients with the HeartWare device. Specifically, the incidence per 100 patient-years of ischemic HRAEs was 2.9% vs. 15.3% and of bleeding HRAEs was 11.8% vs. 18.0%. However, Guglielmo Gallone, MD, et al., found the trade-off between bleeding and ischemic HRAEs was better matched in the HeartWare cohort than the HeartMate 3 cohort, with a difference between the events of 2.7 vs. 8.9% per 100-patient years, respectively. In an accompanying editorial comment, Cristiano Amarelli, MD, writes that the disproportionate incidence of hemorrhagic events reported in the HeartMate 3 population represents a call for action for new anticoagulation protocols.

An observational study designed to characterize patients with asymptomatic hypertrophic cardiomyopathy (HCM) found that about one in four of the 10,143 patients followed for nearly two decades progressed to a symptomatic state over time, and that approximately 40% had obstructive HCM (oHCM) and significantly worse long-term survival than those with nonobstructive HCM (nHCM). Shada Jadam, MD, et al., reported survival rates for oHCM at 5, 10, 15 and 20 years were 89%, 77%, 64% and 50%, compared with nHCM at 91%, 80%, 69% and 57%, respectively. Age, female sex, history of AFib and oHCM vs. nHCM phenotype were independently, significantly associated with long-term higher risk of death.

JACC: Heart Failure
An analysis of the STRONG-HF trial from Rahul Aggarwal, MD, et al., found that an algorithm-driven high-intensity titration of beta blockers, ACEI/ARB/ARNIs and mineralocorticoid receptor agonists within two weeks of HF hospitalization reduced rates of 180-day all-cause death and HF readmissions compared with usual care regardless of ischemic or nonischemic etiology, although ischemic patients had higher rates of readmission.

JACC: CardioOncology
A single center study conducted in Madrid, Spain, by Nerea Mora-Ayestarán, MD, et al., found that among consecutive patients with hereditary transthyretin amyloidosis (ATTRv) systematic cascade genetic screening identifies a median of two genetic carriers per proband in families with ATTRv. Of more than 700 at-risk relatives in 86 families, 62% underwent genetic testing, with a median of five relatives per family screened. Affected relatives were diagnosed at a younger age than their probands (53 years vs. 66 years; p<0.001) and started disease-modifying therapies sooner (57 years vs. 66 years; p<0.001). Older age in proband, living in a different province or country from the proband, male sex and distance relationship with proband were independent predictors of no genetic screening. Of note, nearly one-third of relatives did not undergo genetic testing.

Access all JACC Journals' simultaneous publications on the JACC Journals at ESC Congress 2025 page.