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August Newsletter - Editorial by Stephan Windecker, EAPCI President

Following the recent presidential criss-cross during EuroPCR 2014, the newly elected Board and its committees are well established and running. Throughout this newsletter you will be introduced to some features and updates which have been initiated since then. The goals of our Association are multiple and to accomplish them the EAPCI counts on the commitment of our active members. These members work at the level of the National Societies and Working Groups, but also internationally within the Association itself and through our various committees.

This edition of the EAPCI newsletter will coincide with the ESC 2014 congress in Barcelona. This meeting has matured to the largest congress in the field of cardiovascular medicine worldwide with more than 30,000 participants expected to exchange scientific knowledge and novelties. This year’s programme promises to be particularly attractive with numerous hot line sessions and clinical trial updates, basic and translational science session, Focus sessions including live case transmissions with direct relevance for daily practice, cases in crossfire, meet the experts, and many updates covering all areas of cardiovascular medicine.

ESC Congress 2014 has particular importance for the interventional community and EAPCI for several reasons:

  • The Training & Education committee will be achieving an important milestone by awarding the first certificate of excellence in training in interventional cardiology. This certificate will be announced during the inaugural ceremony of the 2014 ESC Congress, and awarded to Marc Hartmann, The Netherlands for having successfully completed the training. This certificate is linked to the ESC eLearning platform, which was created several years ago to be an interactive, web-based educational tool accessible throughout Europe and internationally.
  • On Sunday 31 August, the new version of the joint ESC/EACTS myocardial revascularization guidelines which was developed with the special contribution of EAPCI will be presented together with four other guidelines (Room Barcelona, Central Village, 14:00 - 15:30). The entire document will be published simultaneously online in the European Heart Journal, EJCTS and EuroIntervention. The first edition of the joint myocardial revascularization guidelines spearheaded by William Wijns and Philippe Kolh in 2010 introduced the notion of the Heart Team which since served as a role model and has become integral part of many other guideline documents. This year’s edition – as the previous one - was compiled by a group of experts consisting of non-invasive cardiologists, interventional cardiologists and cardiovascular surgeons under the chairpersons Stephan Windecker and Philippe Kolh. As part of their work and for the first time, the task force performed a systematic review of all randomized clinical trials comparing coronary artery bypass surgery, percutaneous coronary intervention with various devices including balloon angioplasty, bare metal stents, early generation drug-eluting stents and new generation drug-eluting stents, and medical therapy in patients with stable coronary artery disease between 1980 and 2013. The results of this analysis informed the task force and have been published separately in the British Medical Journal (BMJ 2014;348:g3859 doi: 10.1136/bmj.g3859). Important updates relate to the appropriate selection of CABG and PCI in patients with three-vessel and left main coronary artery disease, among diabetic patients and those with chronic kidney disease, the use of revascularization in various clinical settings including NSTE-ACS, STEMI, congestive heart failure and cardiogenic shock. Antithrombotic therapy in patients undergoing revascularization is also reviewed in detail and incorporates important considerations related to the use of novel P2Y12 inhibitors, pretreatment in patients with ACS and the use of direct thrombin inhibitors in STEMI. For the first time the document also contains a section on volume-outcome relationship providing guidance as it relates to operator and institutional competence in CABG and PCI.
  • Also on Sunday 31 August, the joint consensus document of the ESC WG thrombosis, EHRA, ACCA and EAPCI on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve intervention will be presented. This document under the leadership of Gregory Lip is an important update of the previously published document in 2010. It includes notable changes as it relates to the preferential recommendation of drug-eluting stents over bare metal stents in patients requiring oral anticoagulation as long as they are at low bleeding risk. It also addresses for the first time the issue of antithrombotic therapy in patients undergoing transcatheter heart valve interventions. This document will also be published simultaneously in the European Heart Journal.
  • Several late breaking trials with relevance for the field of interventional cardiovascular medicine will be presented and will inform clinical practice in years to come.

Apart from the congress activities, the Association continues to be involved in numerous additional activities:

  • Thus, the ESC Task Force on Medical Devices under the leadership of Prof. Panos Vardas and Prof. Alan Fraser has delegated the task to revise the EU medical device advisory document on the evaluation of coronary stents (MEDDEV 2.7.1., Appendix 1) to EAPCI with the request to establish an expert advisory group in the field of percutaneous coronary intervention with specific expertise in the evaluation of coronary artery stents. The Task Force established by EAPCI has completed the assignment in July 2014 and the document is currently under review by the ESC and other stakeholders.
  • Only shortly after completion of the ESC congress, our Association will take part in PCR London Valves, the largest course on transcatheter valve therapy which will take place on 28-30 September 2014 in London.

As an Association, the EAPCI is privileged to be supported by many talented individuals willing to take on the responsibilities in committees and various task forces. It is with this joint effort that we are able to promote new knowledge, education and ensure the highest quality of care for patients.

Prof Stephan Windecker, FESC
EAPCI President 2014-2016