ESC 2026 Recap: 5 Practice-Changing Trials to Know

The European Society of Cardiology (ESC) Congress 2026, in Munich, Germany, was a hotbed for major trial readouts and key cardiology news. With hundreds of late-breaking and Hot Line sessions over 4 days of the conference, a plethora of headlines were presented almost at once. From hypertrophic cardiomyopathy and heart failure to dyslipidemia and amyloidosis, ESC 2026 saw updates in just about every major subspecialty within the larger cardiology field.

With so much news coming out of this conference, it was easy to miss even some of the biggest stories and presentations. After our on-site coverage of the full congress, the HCPLive editorial team has collected 5 of the most impactful headlines from ESC 2026 that you may have missed below:

Aficamten Safe, Efficacious in nHCM, Improves Symptoms and Exercise Capacity

Full results from the ACACIA-HCM trial were presented at ESC 2026 by Ahmad Masri, MD, MS, the cardiomyopathy section head at Oregon Health & Science University and director of the OHSU hypertrophic cardiomyopathy center. This trial compared aficamten to placebo in patients with non-obstructive hypertrophic cardiomyopathy (nHCM) – patients receiving aficamten saw substantial improvements in symptom burden and exercise capacity.

SHASTA-3/4: What an 80% Triglyceride Cut Means, With Christie Ballantyne, MD

The SHASTA-3 and SHASTA-4 trials, which investigated RNAi therapeutic plozasiran for patients with severe hypertriglyceridemia, both achieved their primary endpoints of triglyceride reductions. In SHASTA-3, treatment led to a 79% reduction by month 12, while SHASTA-4 saw 81% reductions by the same period. In comparison, placebo achieved around 27% in both trials. In an interview with HCPLive, Christie Ballantyne, MD, professor of medicine, genetics, and physiology at Baylor College of Medicine, explains what these results mean in practice.

The Future of Gene Silencers for ATTR-CM After CARDIO-TTRansform, With Ronald Witteles, MD

The CARDIO-TTRansform study, which investigated the RNA-targeted gene silencer eplontersen in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), failed to achieve its primary composite endpoint of cardiovascular mortality and recurrent events, despite suppressing circulating serum TTR. However, the HELIOS-B trial, which demonstrated the efficacy and safety of the silencer vutrisiran, achieved both its primary and all 4 secondary endpoints years prior. To address this contradiction, Ronald Witteles, MD, of Stanford Medicine, spoke with HCPLive and explained that, despite recent stumbles, silencer therapies are still extremely viable.

TRANQUILITY: Pacibekitug Reduces hs-CRP, Inflammatory Biomarkers in CKD

These data, presented by Deepak Bhatt, MD, MPH, MBA, director of Mount Sinai Fuster Heart Hospital, highlighted the efficacy of pacibekitug in reducing inflammatory biomarkers in patients with chronic kidney disease (CKD) at high inflammatory risk. After 30 days of treatment, patients receiving pacibekitug saw significant dose-dependent decreases in hs-CRP, which were sustained through 180 days of follow-up. However, TRANQUILITY was not powered for cardiovascular events – to this end, in an interview with HCPLive, Bhatt discusses the need for further trials to investigate pacibekitug’s potential cardioprotective effects.

STAREE: Statins Reduce Cardiovascular Events But Not Disability in Older Adults

Atorvastatin successfully reduced major cardiovascular events compared to placebo in patients ≥70 years of age without known cardiovascular disease, diabetes, or dementia in the STAREE trial – however, it failed to improve disability-free survival. STAREE was the first large randomized controlled trial to test statin therapy specifically in older adults, and as such the presentation at ESC 2026 aimed to provide evidence to guide the rapidly-aging US population through cardiovascular risk.