Panagiotis Vardas教授  欧洲心脏病学会（ESC）主席

　　<International Circulation>: Can you tell us about the objectives of the co-operation of ESC in China?

　　Prof. Vardas: The European Society of Cardiology is a federal organization with 56 regular member countries and we have a very active international program. We have 38 affiliated societies and the Chinese Society of Cardiology is one of the significant societies. This year we had the opportunity to sign an agreement with the Chinese Society of Cardiology and this agreement is for the next six years. The new Chinese Society leadership is going to collaborate with the European Society of Cardiology to organize a number of scientific activities. We are talking now about another congress which is not synonymous with the Great Wall Congress and also some other activities under the umbrella name of Sino-ESC Cardiovascular Medicine College. However， the European Society of Cardiology is extremely pleased to continue working and participating in this Great Wall Congress which is a marvelous opportunity for us to see so many cardiovascular specialists. So， to make the long story short， the ESC is planning to be here officially at least twice in 2014: in the middle of September and also in the middle of October for the Great Wall Congress.

　　《国际循环》：ESC与中国都有哪些合作？

　　Vardas教授：欧洲心脏病学会（ESC）是由56个常务会员国组成的联邦机构，一直活跃在国际学术界。我们有38个附属学会，中华医学会心血管病学分会（CSC）是其中非常重要的一个。今年我们有机会与CSC签署了一份未来六年的合作协议。CSC的新任领导将与ESC合作组织一系列的科学活动。我们现在正在讨论在长城会之外的另外一项大会中的合作问题，并策划以Sino-ESC心血管医学会名义组织一些其他的学术活动。此次长城会为心血管权威专家的相互交流提供了非常好的机会，我们ESC非常高兴能参加此次大会，并为大会作出自己的贡献。简而言之，ESC计划2014年将至少在中国组织两次官方活动，一个计划在9月中旬举行，另一个计划在10月份的长城会期间举办。

　　<International Circulation>: What were some of the highlights of the ESC 2013 Meeting in Amsterdam and specifically the five take-home messages which you have also repeated here regarding the joint forums?

　　Prof. Vardas: Undoubtedly in Amsterdam we had a lot of scientific presentations， but the most important I think was the announcement of the new guidelines. We had guidelines for hypertension in collaboration with the European Society for Hypertension; guidelines for diabetes management in collaboration with the Diabetes Association， guidelines for pacing; and guidelines for stable angina as well. If you go through all of these guidelines， you recognize important messages. For example， how increased blood pressure should be treated. We now believe that a maximum systolic blood pressure of 140mmHg (instead of the previous 130mmHg) is quite acceptable. Looking at the new pacemaker guidelines for example， we have a number of simple messages relating to the indications for pacemakers especially in unexplained syncope and so on. With regard to atrial fibrillation and the new anticoagulants， one of the main messages in the Congress was the trial that indicated that mechanical valves could not be treated with the new anticoagulants， at least with dabigatran， because this trial was terminated prematurely. I think the messages from the congress in Amsterdam are coming mostly from the new guidelines.

　　《国际循环》：刚刚在阿姆斯特丹结束的ESC 2013年科学年会的亮点有哪些？在本届长城会联合论坛上你所提到的ESC 2013五大提示分别是什么？

　　Vardas教授：我们在阿姆斯特丹举行的2013年ESC年会上组织了很多精彩的科学演讲，但我认为最重要的亮点还是新指南的发布。我们与欧洲高血压学会合作发布了高血压指南，与欧洲糖尿病协会合作发布了糖尿病管理指南。此外，还发布了心脏起搏指南及稳定性心绞痛管理指南。上述指南为大家带来了很多的讯息。例如，血压增高至多少应该进行治疗。就降压治疗目标而言，原来我们认为应将收缩压降至130 mmHg，而现在我们则认为降至140 mmHg也是可以接受的。新发布的起搏器指南则更新了起搏器的适应证，尤其是不明原因晕厥等情况下应用起搏器的适应证。就心房颤动及新型抗凝药物而言，ESC年会的一大亮点就是公布了相关临床试验结果。其中一项提前终止的试验提示人工瓣膜置换术后不能应用新型抗凝剂，至少不能应用达比加群。我认为在阿姆斯特丹举行的ESC 2013年科学年会的主要提示及讯息还是来源于新发布的各项指南。

　　<International Circulation>: When using dabigatran with reference and in preference to other anticoagulant therapies， what can you tell us about the recommendations made in these important new ESC2013 guidelines?

　　Prof. Vardas: The ESC Guidelines do not suggest a hierarchy for the new anticoagulants， however there is another paper from the European Arrhythmia Association in collaboration with ESC which indicated how to use these new oral anticoagulants. There are a lot of different estimations according to different cases. It is clear that dabigatran as well as the other new anticoagulants are superior to warfarin in preventing ischemic stroke and also in preventing hemorrhagic stroke. If I had to explain why dabigatran is better than warfarin， the answer is very simple – because properly treated， the patient on dabigatran has less possibility of developing ischemic stroke in atrial fibrillation but also this patient has less possibility of developing hemorrhagic stroke compared to treatment with warfarin.

　　《国际循环》：ESC 2013年发布的上述新指南，对与其他口服抗凝药相比达比加群的应用做了怎样的推荐？

　　Vardas教授：ESC指南对新型抗凝药物未做分级推荐。与之不同，欧洲心律失常协会与ESC联合发布的一项声明对如何应用新型口服抗凝药进行了推荐，指出要根据不同的情况进行多项评估。很显然，与华法林相比，达比加群及其他新型抗凝药预防缺血性卒中及出血性卒中的效果更佳。我们说达比加群优于华法林，原因非常简单。主要是因为只要治疗得当，与华法林相比，房颤患者应用达比加群发生缺血性卒中及出血性卒中的风险更低。