The 2017 Innovations in Coronary Artery Disease(ICCAD) meeting in Venice, Italy brought together scientists, physicians, and surgeons from 55 countries around the world, who were able to interact and expound on a broad range of new advances and new directions in the field of coronary artery disease. This bench-to-bedside approach allowed for a comprehensive overview of innovations in coronary artery disease.

he 2017 American Heart Association (AHA) Scientific Sessions took place in Anaheim, CA, USA from November 11 to 15, 2017. A special highlight was the presentation of the new guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults as a collaborative guideline of the AHA together with the American College of Cardiology (ACC) and several other organizations.1 Furthermore, in the aftermath of the presentations and publications of the CANTOS trial results2,3 during the Annual Congress of the European Society of Cardiology (ESC) in Barcelona in September, some relevant additional analyses from this innovative anti-inflammatory treatment were presented. In addition, a large trial examining the effect of bicarbonate and acetylcysteine on renal outcomes after angiography (PRESERVE trial) was presented.5 Finally, additional highlights from the field of heart failure and post–myocardial infarction will be summarized here.

The year 2017 was remarkable as it was the 40th anniversary of the first percutaneous transluminal coronary angioplasty, which was performed on September 16, 1977 by Andreas Grüntzig in Zurich, Switzerland. This revolutionary achievement changed the scope of angiographic procedures from purely diagnostic to therapeutic. The procedure offered an alternative to surgical revascularization because it was not only a symptom-resolving, but also a life-saving procedure. It is hard to imagine modern cardiology without interventions. The number of coronary angiographies performed in the US exceeds 1 million per year, with a percutaneous intervention comprising almost half of the procedures, which results in a direct cost of over $30 billion; similar trends are observed in Europe.1 There is no doubt that the fast-progressing advances in the management of coronary artery and valvular heart diseases dramatically increased patient survival and quality of life. 

Diabetes mellitus and heart failure affect a significant proportion of the population worldwide. Estimates of the prevalence of heart failure vary between 1% and 2% of the general population, and the number of patients with heart failure continues to grow, particularly due to the increase in life expectancy and the resulting aging of the population. Similarly, diabetes mellitus is a matter of concern due to the epidemic of this condition worldwide, particularly in emerging countries due to changing lifestyles; current estimates show that diabetes affects 400 million people worldwide.1 As a result, many patients with heart failure have diabetes mellitus, and, conversely, heart failure is an important complication for patients with diabetes mellitus. The objectives of this article are to review the epidemiological data, the clinical outcomes, and the management peculiarities of patients affected by both diabetes mellitus and heart failure.

Cardiovascular disease is the leading cause of death in developed countries and an increasing problem in low- and middle-income countries. According to the most recent report from the American Heart Association, cardiovascular disease was the most common underlying cause of death in the world in 2013, accounting for an estimated 17.3 million of the 54 million total deaths or 31.5% of
all deaths worldwide. In Europe, each year cardiovascular disease causes an estimated 3.9 million deaths, accounting for 45% of all deaths.

During the last decades, mortality related to cardiovascular disease has significantly declined in most developed countries. However, despite the extraordinary advancements made in understanding the pathogenesis of atherosclerotic cardiovascular disease and the development of new therapeutic targets, the prevalence of traditional risk factors and established cardiovascular disease are growing. Currently, an estimated 92.1 million adults in the US have at least one type of cardiovascular disease, but, by 2030, 43.9% of the US adult population is projected to have some form of cardiovascular disease. Cardiovascular disease also appears as one of the main sources of health care spending and one of the principal determinants of disability. Cardiovascular disease and stroke accounted for 14% of total health expenditures in 2012 to 2013, which is more than any other major diagnostic group. The annual direct and indirect cost of cardiovascular disease and stroke in the US was an estimated $316.1 billion in 2012 to 2013. 

The 2017 annual Scientific Sessions of the American College of Cardiology in Washington, D.C. reviewed the updates in cardiology from 2016, with a specific focus on heart failure.

The 2017 ESC congress, one entire session titled “Valuable lessons on frequent diseases – insights from ESC registries” was dedicated to the EURObservational Research Programme (EORP).1 Alec Vahanian (FR), the EORP Oversight Committee chairman, presented the EORP, which was started in 2009 by the ESC to obtain epidemiological, diagnostic, and therapeutic data to improve the understanding of cardiovascular diseases and facilitate adherence to the guidelines. There are 20 registries that constitute EORP,
which are categorized as general registries (Heart Failure, Atrial Fibrillation General, Chronic Ischemic Cardiovascular Disease, Acute Coronary Syndrome STEMI), sentinel registries (Atrial Fibrillation Ablation, TransCatheter Valve Treatment, European Lead Extraction ConTRolled, Epicardial/Hybrid Atrial Fibrillation Ablation Registry, Valvular Heart Disease II), special registries (Registry Of Pregnancy And Cardiac Disease, PeriPartum CardioMyopathy, Cardiomyopathy and Myocarditis, Cardiac Oncology Toxicity, European Infective Endocarditis Registry), and prevention registries (EuroAspire IV and EuroAspire V). Currently, 100,000 patients from more than
2 200 centers have been enrolled in the EORP registries.1,2

Heart failure (HF). as one of the leading causes of death and disability, is an im- for health care systems around the world. Due to the high rates of hospitalization, readmission, and outpatient visits, the disease continues to remain a costly condition; the management of which requires many human and economic resources. In this regard, the search for strategies to optimize the management of the HF patients is particularly relevant.

The 14th Global CardioVascular Clinical Trialists Forum was attended by rep- resentatives from academia, industry, regulatory authorities, and patients to discuss contemporary cardiovascular outcome trials. In a session titled "Positive signals from recent neutral heart failure trials: time for an autopsy," which was chaired by Mona Fiuzat (US) and Christopher O'Connor (US), investigators from several of the most discussed HF trials in recent years gave their viewpoints on why the trials did not render a positive result. The lessons learned encompassed most aspects of a clinical trial and the absolute necessity of complete control and oversight of the trial to avoid disappointments further down the line was emphasized.

The 2017 annual meeting of the European Society of Cardiology took place in Barcelona, Spain, and, despite the terrible events that transpired less than 2 weeks before the congress in La Rambla, one of the most famous points in the city connecting Plaça de Catalunya in the center with the Christopher Columbus Monument at Port Vell, it did not prevent almost 32 000 people from gathering in the Fira Gran Via to renew their commitment to foster science for the benefit of those afflicted by, or at risk of, cardiovascular disease. As usual, the Congress was the place for breakthrough clinical trials to be presented, some of which are highlighted in this paper.

The 2017 Heart Failure Congress and the 4th World Congress on Acute Heart Failure took place in Paris, France. The congress was a unique forum where heart failure professionals from around the world met and exchanged ideas and information. The congress was attended by 5024 participants from 121 countries, with a large faculty of 287 international experts. The record number of abstracts (1704; up by 151 from the previous year) and case study submissions (253; up by 36 from the previous year) has established the 2017 Heart Failure Congress as the largest and most influential heart failure meeting in the world. Besides its attractive core program, this year's congress had several distinct and attractive features, including three late-breaking trial sessions, guidelines into practice track, HFA championships, HFA grand debates, and off-the-record sessions.

Despite the clear-cut benefits of modern cardiovascular pharmacotherapy, the D majority of patients remain undertreated. Blood pressure control is poor even when hypertension is detected and treated. There is growing evidence that low adherence to treatment is the most important cause of apparently resistant hy- pertension. Several recent reports focused on detection, predisposing factors, and consequences of treatment nonadherence, and these reports suggested different methods to improve treatment adherence.

Each year, after a congress, we have new challenges to tackle, which is also true after the 2017 ESC congress, especially in the field of chronic coronary artery disease. What shall we propose to our patients when talking about new therapies? Should we talk about survival or should we talk about quality of life? Once more, at this year's ESC congress, new clinical trial data was presented. Of them, I recall three trials that might be adequate to this discussion, PEGASUS TIMI 54, and CANTOS.

Cardiac rehabilitation is a complex intervention offered to patients diagnosed with heart disease, and it includes components of health education, advice on cardiovascular risk reduction, physical activity, and stress management. There is increasing evidence that cardiac rehabilitation reduces mortality, morbidity, and unplanned hospital admissions and improves exercise capacity, quality of life, and psychological well-being and it is now highly recommended for both patients after an acute coronary event or revascularization and patients with heart failure, as clearly stated in the European guidelines.1 Unfortunately, referral to and participation in cardiac rehabilitation programs varies widely across countries. Many cardiac rehabilitation programs do not include unstable patients, patients with heart failure, devices, or peripheral artery disease, and the referral and retention of both women and older, higher risk patients remain suboptimal. The guidelines recommend referrals to be increased through electronic prompts or automatic referrals, while patient uptake may be improved with a structured follow-up by nurses or therapists and early entry into cardiac rehabilitation programs after discharge.

In June 2017, 6 200 participants from 90 countries gathered to attend the Europace – Cardiostim congress in Vienna, Austria. The program of this major scientific event included 156 sessions covering the following main topics: (i) atrial fibrilla- tion; (ii) devices and syncope; (iii) cardiac resynchronization therapies; (iv) basic science and genetics; (v) catheter ablation; and (vi) innovative products and tech- niques. This review will discuss the main scientific presentations related to atrial fibrillation, devices and smartphone applications for detecting arrhythmias, and ablation for patients with arrhythmias.