ESC 2019 New Released Guidelines Present Most Relevant Evidence in Acute Pulmonary Embolism, Chronic Coronary Syndromes, Supraventricular Tachycardia and Cardiovascular Prevention
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ESC Guidelines present relevant evidence to help physicians weigh the benefits and risks of a particular diagnostic or therapeutic procedure. Following new released guidelines should be essential in everyday clinical decision making in chronic coronary syndromes, pulmonary embolism, supraventricular arrhythmias, the prevention of cardiovascular risk in in group of type 2 diabetes mellitus or dyslipidaemias.

Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). "2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC)" presented refer to the management of patients with CCS.

"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)" follows the previous ESC Guidelines focusing on the clinical management of pulmonary embolism (PE), published in 2000, 2008, and 2014. Many recommendations have been retained or their validity has been reinforced; however, new data have extended or modified our knowledge in respect of the optimal diagnosis, assessment, and treatment of patients with PE. These new aspects have been integrated into previous knowledge to suggest optimal and—whenever possible—objectively validated management strategies for patients with suspected or confirmed PE. For further details specifically related to the diagnosis and management of deep vein thrombosis (DVT), the reader is referred to the joint consensus document of the ESC Working Groups of Aorta and Peripheral Vascular Diseases, and Pulmonary Circulation and Right Ventricular Function.

Supraventricular arrhythmias (SVT) are common and patients are often symptomatic, requiring management with drugs and electrophysiological procedures. There is a need to provide expert recommendations for professionals participating in the care of patients presenting with SVT. In addition, several associated conditions where SVTs may coexist need to be explained in more detail.“2019 ESC Guidelines for the management of patients with supraventricular tachycardia - The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC)” summarizes current developments in the field, with a focus on advances since the last ESC Guidelines were published, and provides general recommendations for the management of adults with SVT based on the principles of evidence-based medicine.

The interval between preparing the previous Guidelines and "2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD)" has been relatively short, but it has been a period in which we have seen an unprecedented increase in the evidence base available for practicing healthcare professionals to refer to in their daily consultations. This has been characterized by the presentation and publication of a number of CV safety trials for type 2 DM (T2DM) treatments, the results of which, to the casual observer, must seem both exciting and bewildering. Exciting, because while all the recent studies have reported CV safety, several have also reported, for the first time, clear evidence of CV benefit. Bewildering, because these trials continue to be dogged by various side effects that dull the clarity of decision-making. It is one of our aims to guide the reader through this important data set.In other ways, and on a global scale, little has changed. The prevalence of DM worldwide continues to increase, rising to 10% of the population in countries such as China and India, which are now embracing western lifestyles. In 2017, 60 million adult Europeans were thought to have T2DM—half undiagnosed—and the effects of this condition on the CV health of the individual and their offspring create further public health challenges that agencies are attempting to address globally. These massive numbers led to the prediction that >600 million individuals would develop T2DM worldwide by 2045, with around the same number developing pre-DM. These figures pose serious questions to developing economies, where the very individuals who support economic growth are those most likely to develop T2DM and to die of premature CVD. Awareness of specific issues associated with age at onset, sex, and race—particularly the effects of T2DM in women (including epigenetics and in utero influences on noncommunicable diseases)—remains of major importance, although there is still much work to be done. Finally, the effects of advancing age and comorbidities indicate the need to manage risk in an individualized manner, empowering the patient to take a major role in the management of his or her condition.The emphasis in the current document is to provide information on the current state of the art in how to prevent and manage the effects of DM on the heart and vasculature. Our aim has been to focus mostly on the new information made available over the past 56 years, and to develop a shorter, concise document to this end. The need for more detailed analysis of specific issues discussed in the present Guidelines may be met by referring to the plethora of specialist Guidelines from organizations such as the ESC and the American Diabetes Association (ADA).

These novel ESC/EAS Guidelines on lipids provide important new advice on patient management, which should enable more clinicians to efficiently and safely reduce CV risk through lipid modification. “2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)” has been developed for healthcare professionals to facilitate informed communication with individuals about their CV risk and the benefits of adopting and sustaining a healthy lifestyle, and of early modification of their lipid-related CV risk.