At the end of August 2026, the European Society of Cardiology (ESC) Congress once again drew global attention. The event, which brought together representatives from more than 100 countries, demonstrated that modern medicine is undergoing a profound transformation. The integration of artificial intelligence, new disease classifications, and large-scale studies capable of changing clinical practice were among the key topics that shaped this year’s congress agenda.
Artificial Intelligence as an Integral Partner for Physicians
One of the main focuses of this year’s congress was artificial intelligence. According to ESC President Thomas Lüscher, the technology will take diagnosis and prevention to an entirely new level. To this end, the ESC AI Gateway platform was established to help the medical community reliably integrate new algorithms into clinical practice.
The technological advances presented at the congress show that artificial intelligence can predict cardiovascular disease years in advance. For example, an algorithm developed by the University of Oxford detects otherwise invisible inflammation in the coronary arteries on computed tomography (CT) scans and predicts the risk of a heart attack up to 10 years in advance. At the same time, a model has been developed that can use mammograms performed for cancer screening to determine the risks of hypertension and stroke with high accuracy. In addition, new systems can now detect previously invisible heart attacks and diastolic dysfunction from a standard ECG—conditions that previously required complex echocardiographic examinations.
A New Definition of Myocardial Infarction and Updated Guidelines
Major changes have also been introduced in clinical guidelines that are expected to reshape medical practice worldwide. Four leading cardiology organizations have approved the 5th Universal Definition of Myocardial Infarction. The previous numerical classification from 1 to 5 has been abandoned, and myocardial infarction is now divided into three main categories: spontaneous (primary), secondary, caused by an imbalance between oxygen supply and demand, and procedure-related cases.
The classification of heart failure has also changed substantially. Specialists have eliminated the “heart failure with mildly reduced ejection fraction” (HFmrEF) phenotype, leaving patients divided into two groups: reduced (<50%) and preserved (≥50%) ejection fraction. In addition, the term “acute heart failure” has been removed from the medical lexicon and replaced with “decompensated heart failure,” which more accurately reflects the course of the condition. For the first time, dedicated guidelines have also been developed for cardiac rehabilitation and the management of chronic kidney disease.
Clinical Trials That Could Change Decades of Practice
The results of numerous large-scale studies were unveiled during the so-called Hot Line sessions. Among them was the Australian STAREE trial, which showed that using atorvastatin for primary prevention in patients over 70 reduces the risk of cardiovascular events by 30%. Importantly, the medication did not increase the risk of dementia or physical disability. Meanwhile, a seven-year study conducted in China showed that strict and intensive blood pressure management reduces the risk of developing dementia by 15%.
An important clinical dilemma was also addressed in patients who simultaneously require transcatheter aortic valve implantation (TAVI) and coronary stenting (PCI). The TAVI PCI study demonstrated that a strategy of performing TAVI first is both effective and safe, giving physicians greater flexibility in determining the treatment sequence. For patients at average risk of stroke, the SINGLE-AF study clearly showed that the use of direct oral anticoagulants (DOACs) reduces the risk of stroke and death by 69%, without increasing bleeding rates.
Breaking Myths and Social Responsibility in Cardiology
This year’s congress went beyond clinical parameters. University of Oxford Professor Colin Baigent challenged one of the most widespread myths about statins. Drawing on a large-scale meta-analysis, he explained that muscle pain—which often leads patients to discontinue treatment—is, in the overwhelming majority of cases, not caused by the medication. According to the physician, misinformation can seriously harm people’s health, making it essential to combat the problem.
Attention was also given to “green cardiology” and women’s health. Studies showed that interventional procedures in hospitals generate tons of medical waste every year, and proper waste segregation could significantly reduce the environmental impact. In women’s cardiology, specialists emphasized that traditional angiography often fails to detect the microvascular dysfunction commonly seen in women. Therefore, it is essential to address gender disparities in diagnosis and actively develop dedicated women’s heart centers.
