European Society of Cardiology 2026 Preview: 6 Trials to Know

The European Society of Cardiology (ESC) Congress 2026, set to begin on August 28, 2026, in Munich, Germany, will collect some of the biggest trials and most impactful news in cardiology over the last 12 months. From heart failure and stroke to cardiomyopathy and lipid-lowering, every headlining disease state will be addressed during this 3-day conference. Major potential treatments like aficamten and pacibekitug will prove their potential, while data from terminated trials like LIBREXIA ACS and CARDIO-TTRansform will provide valuable insights into future treatment strategies for underrepresented populations.

The HCPLive editorial team will be on-site in Munich for the duration of the conference, providing written coverage and key clinician interviews. Keep an eye on our comprehensive coverage here – and in the meantime, check out what to expect from ESC 2026 below:

Trials to Watch

1. ACACIA-HCM: Aficamten for symptomatic nonobstructive hypertrophic cardiomyopathy

Presentation Time: 11:45 am CEST on Friday, August 28

Presenter: Ahmad Masri, MD, MS

Cytokinetics’ cardiac myosin inhibitor aficamten saw positive topline results in patients with non-obstructive hypertrophic cardiomyopathy (HCM) in May 2026, outperforming placebo in improvements to both the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) and maximal exercise performance. The trial also saw no new safety signals – treatment was well-tolerated, with similar numbers of patients completing planned dosing with aficamten and placebo. This presentation will mark the first release of full trial data from ACACIA-HCM – Cytokinetics is already in talks with the FDA and other regulatory authorities regarding next steps.

2. LIBREXIA ACS: Milvexian after recent ACS

Presentation Time: 11:00 am CEST on Saturday, August 29

Presenter: Phillippe Gabriel Steg, MD

Factor XI inhibition is among the hottest topics in cardiology this year – although the LIBREXIA ACS trial was terminated in November 2025 after being deemed unlikely to achieve its primary efficacy endpoint, the collected data still present a positive perspective on the new treatment strategy. Milvexian did not prove itself in patients who had experienced acute coronary syndrome (ACS) events, but its failure raises valuable questions regarding patient selection and the drug’s potential in different populations. The collected data, which has been analyzed by parent company Bristol Myers Squibb, will be presented in full at ESC 2026.

3. CARDIO-TTRansform: efficacy and safety of eplontersen in patients with transthyretin amyloid cardiomyopathy

Presentation Time: 11:00 am CEST on Friday, August 28

Presenter: Mathew Maurer, MD

Although the phase 3 CARDIO-TTRansform trial failed to achieve its primary efficacy endpoint of the composite outcome of cardiovascular mortality and recurrent cardiovascular clinical events by week 140 compared to placebo, investigators noted that the data collected regarding eplontersen in transthyretin-mediated amyloid cardiomyopathy (ATTR-CM) may guide the treatment landscape. Parent company Ionis announced on July 9, 2026, that they would continue to examine the data and would present the full results at ESC 2026.

4. LUMINARA: a prospective RCT of a once daily oral relaxin agonist for treating heart failure

Presentation Time: 9:09 am CEST on Sunday, August 30

Presenter: James Januzzi, MD

This phase 2b multi-center study from AstraZeneca is investigating AZD5462, the first oral relaxin family peptide receptor 1 (RXFP1) agonist, for chronic heart failure in roughly 260 patients. The drug is designed to lower systemic vascular resistance and afterload, promoting natriuresis to decrease circulating blood volume without increasing heart rate or triggering acute hypertension. The results of this potential new therapy’s trial run in HF will be presented for the first time at ESC 2026.

5. TRANQUILITY: Efficacy of monthly and quarterly dosing of pacibekitug (IL-6 ligand mAb) targeting inflammation in CKD with high cardiovascular risk

Presentation Time: 8:45 am CEST on Saturday, August 29

Presenter: Deepak Bhatt, MD, MPH, MBA

Positive topline results from this phase 2 trial of pacibekitug in patients with CKD and high cardiovascular risk were presented at ESC 2025, highlighting the IL-6 inhibitor’s rapid, sustained, and deep reductions in high-sensitivity C-reactive protein (hs-CRP) compared to placebo. With an ≥85% reduction in hs-CRP among 143 patients, pacibekitug was well-tolerated and had similar adverse event rates to placebo. Now, parent company Tourmaline Bio will present full data from the trial for the first time at ESC 2026.

6. SHASTA-3/4 12-Month Results

Presentation Time: 5:30 pm CEST on Sunday, August 30

Presenter: Gerald Watts, MD, MBBS, PhD

Plozasiran, an investigational RNA interference therapeutic, is under investigation in the SHASTA 3 and 4 trials led by Arrowhead Pharmaceuticals. Topline results were announced in June 2026, indicating significant triglyceride reductions in both trials from baseline that lasted for 12 months. Additionally, pooling both trials together indicated a significantly reduced acute pancreatitis event rate. Arrowhead will be presenting full data from both trials at ESC 2026 for the first time.