Key results for all 59 Hot Line late-breaking clinical trials presented at ESC Congress 2026 in Munich (August 28-31, 2026), grouped by Hot Line session. Each trial links to the full Synapse analysis with PICO breakdown, expert commentary, and the simultaneous journal publication where available.
59 of 59 trials have reported results.
Last updated
Friday, August 28 · 11:00 - 12:15 CEST
Key result: Eplontersen did not meet the primary composite of cardiovascular death and recurrent cardiovascular events versus placebo through week 140.
Presented by Mathew Maurer, Columbia University Irving Medical Center, New York, USA · Cardiomyopathy · Full analysis · Published in NEJM
Key result: DOAC therapy (apixaban or rivaroxaban) cut the 24-month composite of stroke, systemic embolism, major bleeding, or cardiovascular death by 69% versus no anticoagulation in AF with intermediate stroke risk (0.5% vs 1.5%; HR 0.31, 95% CI 0.10-0.94; p=0.028), driven by fewer ischemic strokes with no increase in major bleeding.
Presented by Boyoung Joung, Yonsei University, Seoul, Republic of Korea · Atrial Fibrillation · Full analysis · Published in NEJM
Key result: The response-tailored antibiotic strategy increased median days alive without antibiotic treatment to 183 versus 169 days with standard therapy (difference 13 days; 95% CI 12 to 13; P<0.001) and was noninferior for safety (8.2% vs. 10.7%; difference -2.4 percentage points; 95% CI -7.7 to 2.7; P<0.001) but had higher relapse rates (5.1% vs. 1.6%).
Presented by Henning Bundgaard, Rigshospitalet, Copenhagen, Denmark · Endocarditis · Full analysis · Published in NEJM
Key result: Aficamten met both primary endpoints versus placebo, improving KCCQ-CSS and peak VO2 at week 36 in symptomatic nonobstructive HCM.
Presented by Ahmad Masri, Oregon Health & Science University, Portland, USA · Cardiomyopathy · Full analysis · Published in NEJM
Key result: An ICD did not significantly reduce the primary composite of sudden cardiac death or hemodynamically significant ventricular arrhythmias versus an implantable loop recorder in patients with LVEF 36-50% and CMR-detected scar (7.8% vs 9.2%; HR 0.76, 95% CI 0.37-1.58), though sudden cardiac death alone fell (HR 0.26) and patients under 70 saw a 72% reduction in the primary endpoint.
Presented by Joseph Selvanayagam · Devices & Arrhythmias · Full analysis · Published in JAMA
Saturday, August 29 · 08:15 - 09:45 CEST
Key result: In the STAREE trial, atorvastatin reduced major cardiovascular events compared to placebo (HR 0.70, 95% CI 0.61-0.82; P<0.001) but did not significantly affect disability-free survival.
Presented by Sophia Zoungas, The George Institute for Global Health, Australia · Prevention · Full analysis · Published in NEJM
Key result: The primary outcome of LDL-C <55 mg/dL and ≥50% reduction at 12 months was achieved in 82% with evolocumab vs 40% with standard care (adjusted OR 5.54, 95% CI 4.50-6.82; P < .001).
Presented by Gilles Montalescot · Lipids · Full analysis · Published in JAMA
Key result: Pacibekitug produced sustained, dose-dependent hs-CRP reductions through day 180 versus placebo (+7% vs −76% / −85% / −89% across 25 mg q90d, 50 mg q90d, and 15 mg q30d; all p<0.0001), with no clear dose-related safety signals.
Presented by Deepak Bhatt · Prevention · Full analysis
Key result: Silent atherosclerosis was present in 57.1% of 16,808 asymptomatic adults aged 18–70, including 1 in 13 aged 18–29 and 9 in 10 aged 60–70; SCORE2 classified only a small minority of those with plaque as high risk.
Presented by Henning Bundgaard, Rigshospitalet, Copenhagen, Denmark · Prevention · Full analysis · Published in NEJM
Key result: Edoxaban did not reduce stroke or systemic embolism versus no anticoagulation (11.8% vs 12.8%; HR 0.88, 95% CI 0.61–1.26; p=0.48) and doubled major bleeding (11.6% vs 5.2%; HR 2.23).
Presented by Ashkan Shoamanesh · Atrial Fibrillation · Full analysis
Key result: Expanded DAN-RSV follow-up at ESC 2026: RSVpreF cut RSV-related respiratory hospitalizations versus no vaccine (0.16 vs 0.55 per 1000 person-years; ~70% vaccine effectiveness), published in NEJM Evidence (10.1056/EVIDoa2600272).
Presented by Tor Biering-Sørensen · Prevention · Full analysis · Published in NEJM Evidence
Saturday, August 29 · 11:00 - 12:15 CEST
Key result: Milvexian 25 mg twice daily did not reduce CV death, MI, or ischaemic stroke versus placebo after ACS (5.4% vs 5.1%; HR 1.05, 95% CI 0.91–1.21; p=0.50); intracranial or fatal bleeding was 0.3% in both groups.
Presented by Philippe Gabriel Steg · Acute Coronary Syndromes · Full analysis · Published in NEJM
Key result: Prasugrel monotherapy was not noninferior to 12-month DAPT for death, MI, or stroke at 12 months (11.0% vs 8.5%; HR 1.34, 95% CI 1.02–1.75; p=0.40 for noninferiority).
Presented by Gaku Nakazawa · Acute Coronary Syndromes · Full analysis · Published in NEJM
Key result: At 1 year, the primary endpoint occurred in 11.8% with ticagrelor and 11.1% with prasugrel (adjusted OR 0.90, 95% CI 0.77-1.06), showing no significant difference between the two policies.
Presented by Elmir Omerovic · Acute Coronary Syndromes · Full analysis · Published in NEJM
Key result: Clopidogrel monotherapy was noninferior to extended DAPT for net adverse clinical events at 24 months (risk difference −0.1 percentage points; 90% CI −1.3 to 1.2; P=0.001 for noninferiority).
Presented by Byeong-Keuk Kim · Interventional Cardiology · Full analysis · Published in NEJM
Key result: One month of escalated single antiplatelet therapy with a potent P2Y12 inhibitor plus a direct oral anticoagulant did not reduce ischemic events versus standard therapy (win-loss ratio 1.19) and increased bleeding in patients with atrial fibrillation and acute coronary syndrome undergoing PCI; the trial was stopped early.
Presented by Konstantinos D. Rizas, Ludwig Maximilians University, Munich, Germany · Interventional Cardiology · Full analysis · Published in Nature Medicine
Saturday, August 29 · 16:15 - 17:15 CEST
Key result: The 0/1-hour pathway was noninferior to 0/3-hour for 30-day death or type 1 MI (1.1% vs 1.2%; adjusted OR 0.93, 95% CI 0.77–1.13; p for noninferiority <0.001) but did not reduce median ED length of stay (309 minutes in both groups; p=0.65).
Presented by Christian Eugen Mueller · Acute Coronary Syndromes · Full analysis · Published in The Lancet
Key result: Across five randomised trials and 110,933 ED presentations, the 0/1-hour pathway had similar safety to standard care but did not reduce ED length of stay or increase direct discharge.
Presented by Jasper Boeddinghaus · Acute Coronary Syndromes · Full analysis
Key result: Functional coronary angiography–guided complete revascularisation cut death, MI, stroke, or ischaemia-driven revascularisation versus conventional angiography in STEMI with multivessel disease (8.9% vs 13.7%; HR 0.62, 95% CI 0.47–0.83; p<0.001) at a median 17.9 months.
Presented by Simone Biscaglia · Interventional Cardiology · Full analysis · Published in NEJM
Key result: Routine CTCA after myocardial infarction was ruled out did not reduce subsequent MI or cardiovascular death versus standard care over three years (7.1% vs 7.3%) among 3,170 patients with acute chest pain.
Presented by Nicholas Mills · Imaging · Full analysis · Published in NEJM
Saturday, August 29 · 17:30 - 18:30 CEST
Key result: A digital strategy increased SGLT2 inhibitor initiation at 6 months versus usual care (18.6% vs 8.2%; p<0.001). Heart-failure hospitalisation or death was similar (13.0% vs 14.0%; p=0.276).
Presented by Mariam Elmegaard · Digital Health · Full analysis
Key result: Adding remotely delivered exercise-based cardiac rehabilitation to centre-based programmes did not increase completion of the full exercise programme (13.8% vs 13.6%) or the mean number of completed sessions.
Presented by Maria Bäck · Digital Health · Full analysis
Key result: In adults with recent statin nonadherence, adaptive digital outreach increased 14-day statin refill rates versus usual communication (14.4% vs 12.0%; adjusted risk difference 2.3 percentage points, 95% CI 1.3-3.4; adjusted risk ratio 1.20, 95% CI 1.10-1.30).
Presented by Ankeet Bhatt · Digital Health · Full analysis · Published in JAMA
Key result: VIRTUES remote monitoring was noninferior to standard in-clinic care for death, stroke, or cardiovascular- or device-related hospitalisation at 18 months in ICD (11.0% vs 11.2%; p=0.007 for noninferiority) and pacemaker (6.1% vs 7.4%; p=0.0213 for noninferiority) patients.
Presented by Ratika Parkash · Digital Health · Full analysis
Sunday, August 30 · 08:15 - 09:50 CEST
Key result: Hydralazine-isosorbide dinitrate did not significantly reduce death or heart-failure events versus placebo (8.6 vs 9.3 events per 100 patient-years; HR 0.90, 95% CI 0.67-1.21), and treatment discontinuation was high. All-cause death was 19.4% versus 24.2% (HR 0.72, 95% CI 0.51-1.02).
Presented by Lars Køber, Rigshospitalet, Copenhagen University Hospital, Denmark · Heart Failure · Full analysis
Key result: Pooling three hydralazine-isosorbide dinitrate trials (2,101 patients, including A-HeFT and H-HeFT), H-ISDN was associated with lower all-cause death (HR 0.71, 95% CI 0.58-0.87) and cardiovascular death (HR 0.65, 95% CI 0.47-0.90), but heart-failure hospitalisation results were inconsistent and the investigators concluded that heterogeneity in trial design and tolerability make firm conclusions difficult.
Presented by Jawad Haider Butt, Rigshospitalet, Copenhagen University Hospital, Denmark · Heart Failure · Full analysis
Key result: Metformin did not reduce death, worsening heart failure, myocardial infarction, or stroke versus placebo over a mean 3.7 years in HFrEF with diabetes or prediabetes (25.1% vs 23.4%; HR 1.10, 95% CI 0.84-1.42; p=0.48).
Presented by Henrik Wiggers · Heart Failure · Full analysis
Key result: The pooled analysis reached the same conclusion as the Met-HeFT trial: no significant difference in cardiovascular outcomes with metformin in heart failure with reduced ejection fraction, and no significant effect in established ischaemic heart disease.
Presented by Anders Hostrup Larsen · Heart Failure · Full analysis
Key result: In cohort A, AZD5462 20 mg reduced end-systolic volume index by -5.4 mL/m2 versus placebo at week 25 (95% CI, -10.9 to 0.1; P=0.054). In cohort B, AZD5462 significantly reduced systemic vascular resistance index across all doses (all P<0.05).
Presented by James Januzzi · Heart Failure · Full analysis · Published in Circulation
Key result: Pulmonary-artery denervation plus medical therapy significantly reduced clinical worsening compared to medical therapy alone in pulmonary hypertension associated with left heart disease (HR 0.49, 95% CI 0.30-0.82; P=0.006).
Presented by Shao-Liang Chen, Nanjing First Hospital, Nanjing, China · Pulmonary Hypertension · Full analysis · Published in NEJM
Key result: The intervention increased the probability of surviving 730 days without hospitalization to 84.0% versus 79.4% in usual care (OR 1.78, 95% CI 1.42–2.23) and reduced all-cause mortality by 22% (HR 0.78, 95% CI 0.63–0.95; p=0.028).
Presented by Jeemon Panniyammakal · Heart Failure · Full analysis · Published in Circulation
Sunday, August 30 · 11:00 - 12:15 CEST
Key result: Routine protamine administration after transfemoral TAVI reduced the primary composite of all-cause death or clinically relevant bleeding versus selective protamine (18.5% vs 29.4%; risk difference 10.9 percentage points; p<0.001). Anaphylactic reactions occurred in 1.3% of the routine arm; thromboembolic event rates were ~4% in both arms.
Presented by Christiaan Overduin · Structural Heart · Full analysis
Key result: A TAVI-first strategy was noninferior to a PCI-first strategy in severe aortic stenosis with concomitant coronary artery disease: the primary composite endpoint occurred in 22.2% vs 24.2% at 1 year (risk difference -2.0 percentage points; 95% CI -7.4 to 3.4; p for noninferiority <0.001) among 986 patients.
Presented by Barbara Elisabeth Stähli · Structural Heart · Full analysis · Published in NEJM
Key result: Transcatheter tricuspid-valve repair plus medical therapy significantly improved the hierarchical composite of death, heart failure hospitalization, and quality-of-life at 1 year (win ratio 2.42, 95% CI 1.76-3.33; p<0.001) and reduced death or hospitalization through 3 years (HR 0.40, 95% CI 0.29-0.55; p<0.001).
Presented by Jörg Hausleiter, Ludwig Maximilians University, Munich, Germany · Structural Heart · Full analysis · Published in NEJM
Key result: NOAC monotherapy reduced TAVI valve leaflet thrombosis at 12 months compared to ASA monotherapy (17.2% vs 32.6%; risk ratio 0.55, 95% CI 0.37-0.82; P=0.004) and was noninferior for safety (7.5% vs 10.6%; risk difference −3.3%, 95% CI −9.5% to 2.8%; P for noninferiority <0.001).
Presented by Øyvind H. Lie · Structural Heart · Full analysis · Published in JAMA
Key result: Three months of DOAC therapy after successful TAVI reduced subclinical leaflet thickening (HALT) at 3 months (12% vs 32% with SAPT alone), but the effect was not sustained at 12 months (28% vs 32%), and all-cause mortality, stroke, or major/life-threatening bleeding occurred more often with DOAC (8.2% vs 2.3%).
Presented by Troels Højsgaard Jørgensen · Structural Heart · Full analysis · Published in JACC
Sunday, August 30 · 16:15 - 17:15 CEST
Key result: An mHealth intervention implementing the Atrial Fibrillation Better Care (ABC) pathway combined with comprehensive geriatric assessment did not reduce unplanned hospitalisations versus usual care in older, multimorbid patients with AF. Investigators noted high baseline guideline adherence, low event rates and low use of the mobile app.
Presented by Gregory Y. H. Lip · Atrial Fibrillation · Full analysis
Key result: Catheter ablation for AF did not significantly improve AF-related quality of life versus a double-blind sham procedure (AFEQT summary score 61.3 to 81.1 with ablation vs 59.2 to 74.9 with sham; p=0.36), despite substantially higher freedom from AF at 6 months (73% vs 52%).
Presented by Rolf Wachter · Atrial Fibrillation · Full analysis · Published in The Lancet
Key result: A one-year tailored exercise programme cut AF burden versus usual care (3.9% vs 7.1% of monitored time in AF; p=0.016, a 45% relative reduction) but did not significantly improve AF-specific quality of life (AFEQT overall score change +5.6 vs +4.4; p=0.43).
Presented by Bjarne Nes · Atrial Fibrillation · Full analysis
Key result: In patients with persistent AF and significant low-voltage zones, adjunctive low-voltage zone ablation plus pulmonary vein isolation achieved freedom from atrial arrhythmia in 67.6% vs 37.4% with pulmonary vein isolation alone (OR 3.5, 95% CI 2.0-6.2; p<0.001).
Presented by Astrid Paul Nordin · Atrial Fibrillation · Full analysis · Published in JAMA
Sunday, August 30 · 17:30 - 18:30 CEST
Key result: Quarterly plozasiran 25 mg cut median triglycerides at month 12 by 79% in SHASTA-3 and 81% in SHASTA-4 versus roughly 27% with placebo (p<0.0001 in each trial), and reduced cumulative acute pancreatitis events by 78% across the pooled severe hypertriglyceridaemia population.
Presented by Gerald Watts · Lipids · Full analysis
Key result: In the CRHCP cluster-randomised trial, an intensive blood pressure intervention led by non-physician community healthcare providers reduced all-cause dementia versus usual care: 8.85% vs 10.55%; adjusted risk ratio 0.85 (95% CI 0.78–0.91); p<0.001.
Presented by Shanshan Zhong, The First Affiliated Hospital of China Medical University, Shenyang, China · Hypertension · Full analysis
Key result: Across 51 randomised trials and 357,440 participants, blood pressure-lowering treatment reduced major cardiovascular disease similarly across the spectrum of baseline risk (HR 0.90 per 5 mmHg SBP reduction; p for interaction >0.99). Absolute risk reductions rose from 0.4 percentage points in the lowest predicted-risk decile to 2.6 percentage points in the highest.
Presented by Kazem Rahimi · Hypertension · Full analysis
Key result: In 640 patients with hypertension and chronic kidney disease, a salt substitute (75% sodium chloride / 25% potassium chloride) lowered systolic blood pressure at 3 months by 6.6 mmHg versus 2.0 mmHg with regular salt (p<0.001). Serum potassium rose by 0.2 vs 0 mmol/L, with no episodes of hyperkalaemia.
Presented by Dong Shui · Hypertension · Full analysis
Monday, August 31 · 08:15 - 09:30 CEST
Key result: Immediate 14-day ambulatory ECG monitoring did not reduce mean self-reported syncope episodes at one year versus standard care (1.37 vs 1.58; IRR 0.89, 95% CI 0.68-1.18; p=0.43). Arrhythmia detection more than doubled (22% vs 9%) and all-cause mortality was 1.5% vs 2.9%.
Presented by Matthew James Reed · Devices & Arrhythmias · Full analysis · Published in NEJM
Key result: Targeted left-ventricular lead placement at the latest electrical activation site did not reduce death or first unplanned heart-failure hospitalisation versus standard posterolateral non-apical placement (27.9% vs 25.5%; HR 1.10, 95% CI 0.86-1.39; p=0.45) after a median 45.8 months.
Presented by Jens Cosedis Nielsen · Devices & Arrhythmias · Full analysis · Published in Lancet
Key result: CRT efficacy was robust and similar overall with SyncAV dynamic AV optimisation versus a conventional fixed AV interval. In the subgroup with PR interval ≥185 ms, SyncAV reduced all-cause mortality, heart failure hospitalisations, persistent AF and negative echocardiographic CRT response.
Presented by Niraj Varma · Devices & Arrhythmias · Full analysis
Key result: Upfront pacing reduced the primary composite of recurrent syncope, bradycardia requiring pacemaker, cardiovascular death and device-related complications at 1 year versus standard care in high-risk unexplained syncope (age ≥55 years with DROP score ≥2): 17.2% vs 31.7%; p=0.014.
Presented by Jeremy William · Devices & Arrhythmias · Full analysis
Key result: His/LBB pacing was noninferior to biventricular pacing for left ventricular reverse remodeling: LVESV decreased 35% with His/LBB pacing versus 34% with biventricular pacing.
Presented by Michael Vinther · Devices & Arrhythmias · Full analysis · Published in JACC Clinical Electrophysiology
Monday, August 31 · 13:00 - 14:00 CEST
Key result: Stress imaging-guided selective invasive management did not demonstrate noninferiority to routine invasive management for 1-year death, nonfatal MI, or nonfatal stroke in patients aged 80 or older with NSTEMI (24.1% vs 20.7%; HR 1.22, 95% CI 0.86-1.72; p=0.27). The trial stopped early for futility.
Presented by Gilles Barone-Rochette, University Hospital of Grenoble, France · Interventional Cardiology · Full analysis
Key result: OCT-guided PCI was noninferior to IVUS-guided PCI for 12-month target lesion failure in true distal left main bifurcation lesions (14.4% vs 19.6%; adjusted HR 0.90, 95% CI 0.59-1.36; p for noninferiority=0.0003).
Presented by Yong Zeng, Beijing Anzhen Hospital, Capital Medical University, China · Interventional Cardiology · Full analysis
Key result: Statin initiation guided by coronary artery calcium was not shown noninferior to pooled-cohort-equation risk assessment for MACE over 4.2 years (2.7% vs 2.7%; HR 0.99, 95% CI 0.71-1.38; p=0.045 for noninferiority). Event rates were lower than expected.
Presented by Joseph Muhlestein, Intermountain Medical Center, Utah, USA · Prevention · Full analysis
Key result: In the CoCAP substudy of the TACSI trial, ticagrelor plus aspirin did not improve graft patency compared with aspirin alone when assessed by coronary CT angiography a mean of 20 months after CABG.
Presented by Jonas Holm, Linköping University Hospital, Sweden · Cardiac Surgery · Full analysis
Monday, August 31 · 14:15 - 15:15 CEST
Key result: Immediate coronary angiography did not improve 30-day survival versus a deferred strategy in unconscious out-of-hospital cardiac arrest without ST-elevation (54.6% vs 53.6%; HR 0.95, 95% CI 0.74-1.21; p=0.67).
Presented by Sten Rubertsson, Uppsala University, Sweden · Acute Cardiac Care · Full analysis
Key result: An individual-patient-data meta-analysis of five randomised trials (2,173 patients), including DISCO, found no difference in 30-day survival between immediate and deferred coronary angiography after out-of-hospital cardiac arrest without ST-elevation.
Presented by Lente Pol, Radboud University Medical Centre, The Netherlands · Acute Cardiac Care · Full analysis
Key result: Activation of community first responders did not improve 30-day survival after out-of-hospital cardiac arrest: 15% vs 17% (p=0.42) when estimated responder arrival was under three minutes, and 13% vs 14% (p=0.43) at three to nine minutes. Bystander CPR and defibrillation increased significantly, with no safety concerns.
Presented by Fredrik Folke, Herlev and Gentofte University Hospital, Denmark · Acute Cardiac Care · Full analysis · Published in Resuscitation Plus
Key result: Catheter-directed thrombolysis reduced 7-day all-cause death, PE recurrence, or cardiorespiratory decompensation versus anticoagulation alone in intermediate-high-risk pulmonary embolism (0.7% vs 6.8%; RR 0.10, 95% CI 0.02-0.44; p<0.001). 7-day bleeding was 4.6% vs 5.0% (p=0.846).
Presented by Viktor Kočka, Charles University and University Hospital Královské Vinohrady, Prague, Czechia · Pulmonary Embolism · Full analysis · Published in NEJM
Key result: Concomitant left atrial appendage closure during planned open-heart surgery did not significantly reduce stroke or TIA versus standard care over a median 4.0 years (4.28% vs 5.04%; HR 0.85, 95% CI 0.53-1.37; p=0.517). Patients with CHA2DS2-VASc above the median had a 56% reduction (p=0.018).
Presented by Helena Dominguez, Bispebjerg University Hospital, Denmark · Cardiac Surgery · Full analysis
Key result: In the REVEAL trial, 124I-evuzamitide PET/CT demonstrated a sensitivity of 94% (95% CI, 85%-98%; p<.001) and specificity of 86% (95% CI, 77%-92%; p<.001) for diagnosing cardiac amyloidosis.
Presented by Sharmila Dorbala · Imaging · Full analysis · Published in JAMA