The optimal treatment for heart attack patients will be debated at Acute Cardiovascular Care 2018. The annual congress of the Acute Cardiovascular Care Association (ACCA), a registered branch of the European Society of Cardiology (ESC), will be held 3 to 5 March at the MiCo Milano Congressi in Milan, Italy.
Recommendations for treating heart attack patients, such as time windows for diagnosis and treatment, are outlined in the 2017 ESC guidelines for patients with ST-segment elevation myocardial infarction (STEMI).1
Two 'Great Debate' sessions will focus on controversies, including: whether to perform percutaneous coronary intervention (PCI) of non-infarct-related arteries immediately after primary PCI; the usefulness of risk scores in defining the optimal duration of dual antiplatelet therapy; and whether it is time to reconsider aspirin as a routine therapy for preventing a second heart attack.
Professor Kurt Huber, Chairperson of the Scientific Programme, said: "Hot topics in acute coronary syndromes will be discussed by leaders in the field in several sessions. We will debate, for example, whether antithrombotic therapy should start in the ambulance or the emergency room."
Controversial treatments in acute heart failure, such as whether morphine should be given to all patients with acute pulmonary oedema, will also be debated. The 2016 ESC heart failure guidelines2 recommend switching to sacubitril/valsartan3 if patients do not improve on standard medications. But awareness of the relatively new treatment is low, especially outside specialist clinics, and its use will be examined.
Acute Cardiovascular Care is the leading scientific event for all health professionals caring for acutely ill cardiac patients. It brings together more than 1,000 cardiologists, intensivists, anaesthesiologists, internists, cardiac surgeons, nurses, paramedics and other allied professionals from over 80 countries.
One session is devoted to critically ill patients outside of hospital, who are initially seen by emergency doctors or paramedics. Subjects include what to consider when airlifting cardiac patients, when to terminate resuscitation, the cause and treatment of arrhythmias, and whether extracorporeal membrane oxygenation (ECMO) is an option for patients with cardiogenic shock outside the hospital.
ECMO is another hot topic that will be featured and members of the press can get the latest updates from research and practical experience. The use of extracorporeal cardiopulmonary resuscitation (ECPR) will also be covered extensively. "The use of ECPR is gaining more attention and we have invited the leaders in this area to present their data," said Dr Sergio Leonardi, Co-Chairperson of the Scientific Programme.
The congress theme 'working together for acute cardiovascular patients' highlights the fact that patients with acute cardiac conditions often have other issues - for example with their kidneys or lungs, or an infection - that contributed to the acute situation. Cooperation among many specialists is needed to ensure that patients receive optimal, timely care.
The congress emphasises practical issues in caring for critically ill patients. Hands-on demonstrations and training will be given in the ACCA School, which covers ECMO, pacemakers, implantable cardioverter defibrillators, and renal replacement therapy. These are sessions not to miss for journalists wanting to see and hear the nuts and bolts of treating patients in this field.
Dr Leonardi said: "This is the congress for practical insights into the management of complex patients encountered in everyday clinical practice. Acute cardiac care is a field in which it can be challenging to gather scientific evidence and the congress brings together clinician thought leaders to guide us through some of the most challenging scenarios we face every day."
Professor Huber said: "The special thing about our meeting is that it's very patient-oriented. We discuss the most recent science and recommendations and then talk about what to do with the patient in front of you. This is the most important acute cardiac care meeting of the year."
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More information: The full scientific programme is available here.
1. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal. 2017. DOI: 10.1093/eurheartj/ehx393
2. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2016;37(27):2129–2200. DOI: 10.1093/eurheartj/ehw128.
3. Sacubitril/valsartan is the first in class angiotensin receptor neprilysin inhibitor.