The 2019 annual congress of the European Society of Cardiology (ESC), held with the World Congress of Cardiology of the World Heart Federation, took place in Paris, Porte de Versailles, from August 31 to September 4. With more than 33,500 attendees, this year the largest congress of cardiovascular medicine in the world achieved an all-time record of attendance (fig. 1). The fully renovated venue in downtown Paris, Port de Versailles (fig. 2), was very much appreciated by the attendees because its compactness enabled the majority of activities to take place in a three-story building.

The quality and quantity of late-breaking clinical trials presented was astonishing, reflected by the numerous simultaneous publications in major journals. Of the publications in the highest impact factor journals, 6 were in the New England Journal of Medicine, 8 in the Lancet, 6 in the Journal of the American Medical Association, 14 in the European Heart Journal, 5 in Circulation and 7 in the Journal of the American College of Cardiology. Many trials presented have the potential to change practice. These included: DAPA HF, which showed a beneficial effect of the sodium-glucose transport protein 2 (SGLT2) inhibitor dapagliflozin in heart failure; COMPLETE, which documented the superiority of complete revascularisation over culprit-only percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary disease; ISAR-REACT 5, which demonstrated the superiority of a prasugrel-based over a ticagrelor-based regimen in acute coronary syndromes; THEMIS, which showed a modest benefit in terms of ischaemic event reduction with a combination of aspirin and ticagrelor as compared with aspirin alone, but at the expenses of a sizable increase in major bleeding; and AFIRE, which showed a benefit of rivaroxaban alone over rivaroxaban plus aspirin in patients with atrial fibrillation and stable coronary artery disease.

The contribution of Swiss cardiologists to the 2019 ESC meeting was remarkable. Prof. Marco Roffi from the University Hospitals of Geneva chaired the congress together with Prof. Silvia Priori from Pavia, Italy. They coordinated the efforts of the Congress Programme Committee, which was composed of over 80 internationally recognised experts. Among them were Prof. Francois Mach from the University Hospitals of Geneva for the topic prevention and PD Isabella Sudano from the University Hospital of Zurich for the topic hypertension. Five new ESC guidelines were released at the meeting; discussion of the one on dyslipidaemia was chaired by Prof. Francois Mach together with Prof. Colin Baigent from Oxford, UK and Prof. Alberico Catapano from Milan, Italy. Among the late breaking trials, three Swiss studies were presented. Dr Juan Iglesias from the University Hospitals of Geneva presented the randomised BIOSTEMI study showing the superiority of a biodegradable polymer sirolimus-eluting stent over a durable polymer everolimus-eluting stent in patients with STEMI. The study was published simultaneously in the Lancet. Dr Konstantinos Koskinas from the University Hospital of Bern presented the randomised study EVOPACS, the first investigation showing efficacy and safety of a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor administered in the acute phase of a coronary event. The study was published simultaneously in the Journal of the American College of Cardiology. Finally, Prof. Christian Müller from the University Hospital of Basel presented GALACTIC, the largest investigator-initiated randomised controlled trial in acute heart failure, which showed that comprehensive vasodilator treatment did not improve outcomes.

During the meeting, members of the editorial board of the European Heart Journal, as well as friends and colleagues, gathered for a dinner to celebrate the fantastic performance of Prof. Thomas Lüscher, from the University of Zurich and Imperial College London, UK, as editor-in-chief of the journal. On the last day of the meeting, at the Guidelines Condensed session, which summarises the major findings of the newly released ESC guidelines, Prof. Stephan Windecker (fig. 3) from the University Hospital of Bern received prolonged applause from a packed main auditorium for his outstanding work as chairman of the ESC Guideline Committee. With a total of 58 members, Switzerland ranked number eight in terms of invited faculty. What an incredible contribution!

For 9 years in a row, a group of Swiss cardiologists has cycled from Switzerland to the city hosting the ESC congress. Previous destinations included Paris, Munich (twice), Amsterdam, Barcelona (twice), Rome and London. This year, 20 cyclists covered 700 km and an overall altitude difference of 7000 m in 7 days (fig. 4). They were cheerfully welcomed outside the Hotel de Ville by the ESC leadership and the President of the Swiss Society of Cardiology Prof. Giovanni Pedrazzini. The purpose of this action, in addition to having fun and exercise together, was to increase awareness of cardiovascular disease prevention and to raise money for cardiovascular research in Switzerland. Notably, this endeavour was financed by the participants themselves. The driving force beyond it, Prof. Hans Rickli from the Cantonal Hospital in St Gallen, is already working on next year’s cycling event to Amsterdam!

For those who were not able to attend the meeting, all sessions are available on esc365.escardio.org.I look forward to meeting you all for yet another successful ESC congress in Amsterdam on August 29 to September 2, 2020!