Spotlight Discussion: Management of multivessel disease in patients with acute coronary syndromes

Dr Breda Hennessey graduated from the Third Faculty of Medicine in Charles University in Prague. Following this, she returned to Ireland to complete her general medical and higher specialist cardiology training. In 2019, she was awarded the Brian McGovern Scholarship by the Irish Cardiac Society, and this allowed her to commence her subspecialty training in Interventional Cardiology at Hospital Clínico San Carlos in Madrid. She completed a two-year coronary interventional fellowship, with a focus on intracoronary imaging, invasive physiology and ultra-low dose contrast intervention. Following completion of her coronary training, she undertook a further fellowship in structural intervention, also at Hospital Clínico San Carlos. In addition to her clinical work, she has been involved in various research projects pertaining to ultra-low dose contrast PCI, investigating the impact of new technologies in reducing contrast burden in complex PCI . She has authored and co-authored a number of research articles, book chapters and has contributed to the European association of Percutaneous Cardiovascular Interventions textbook. During her time at Hospital Clinico San Carlos, she completed a Masters in Interventional Cardiology and is currently undertaking a PHD at the Complutense University of Madrid with a focus in ultra-low dose contrast PCI. Throughout her fellowship, she regularly took part in the preparation and delivery of educational courses, both at Hospital Clinico San Carlos and in collaboration with other tertiary referral centres and international cardiology societies in Spain, the UK and the UAE.

Enrique Gutiérrez is an Interventional Cardiologist at Hospital Gregorio Marañón, Madrid. After specializing in Cardiology in Zaragoza, he became an interventional cardiologist, and since 2008 he is a Consultant at Gregorio Marañón. He visited Mayo Clinic under the direction of Prof. Amir Lerman, and subsequently started focusing on coronary physiology, with a special interest in microvascular and endothelial function. He has published papers con coronary physiology assessment and the physiology of the non-culprit artery, and is the lead investigator in the Spanish multicenter registry of acetylcholine test ENDOCOR. He is a member of the ESC working group on Coronary Pathophysiology and Microcirculation, and co-chair of the working group for intracoronary diagnosis of the Spanish Association of Interventional Cardiology.

Prof Javier Escaned is Head of Section (Interventional Cardiology Section) at Hospital Clinico San Carlos / Complutense University (Madrid, Spain). He trained in the United Kingdom as Specialist in Cardiology and obtained his PhD in The Netherlands. Author of >700 indexed scientific articles on interventional cardiology, imaging and physiology (h-index 100) and over 30 years of experience as PCI operator, he regularly lectures and performs live cases at major scientific and educational meetings. He is a recipient of the European Society of Cardiology (ESC) Silver Medal and the Andreas Grüntzig Award for his contributions to the fiedl fo Interventional Cardiology. Main areas of expertise include complex PCI, intracoronary diagnostics and functional coronary angiography. His track record in coronary physiology comprises being investigator on pioneer FFR trials like DEFER (1998), collaborator with Justin Davies in the validation and clinical implementation of iFR, and developer of new tools for the assessment of coronary microcirculation. Editorial roles include Deputy Editor EHJ, Advisory Editor Eurointervention, editor of the textbooks “Coronary Stenosis: Imaging, Structure and Physiology” and “Physiological Assessment of Coronary Stenoses and the Microcirculation". Recent board positions include EAPCI board / Education Committee Chair, ESC WG Coronary Pathophysiology and Microcirculation, EuroCTO Board. Recent trials as Principal Investigator include ADVISE II, DEFINE FLAIR, SYNTAX II, PIONEER IV, Cerebral-Coronary-Connection (C3), DCR4Contrast, INOCA LongCovid and AID ANGIO. Additional interests are philosophy and music.

Dr Justin Davies is a board member of Monaco Cardio at the Princess Grace Hospital, Monaco, and an interventional cardiologist with over 15 years of experience as a leading educator in the field. His clinical and academic career was established at Hammersmith Hospital, Imperial College London, where he built an international reputation for innovation in cardiovascular medicine. Over the course of his career, he has successfully mentored 15 PhD students, published more than 500 peer-reviewed papers — including landmark studies in the New England Journal of Medicine and The Lancet — and holds 20 patents in cardiovascular medicine and technology. He was the co-principal investigator of the DEFINE-FLAIR study, which helped establish iFR (Instantaneous Wave-Free Ratio), a diagnostic technique he invented, as a globally adopted standard in coronary physiology. His work reflects a unique blend of scientific innovation, academic leadership, and clinical excellence. In addition to his research and academic commitments, Justin is CEO of Cerebria AI, where he leads the development of next-generation AI-powered cardiovascular imaging and physiology tools. Under his leadership, Cerebria AI is advancing cutting-edge solutions that integrate artificial intelligence with frontline cardiology to enhance clinical decision-making and patient outcomes. Combining deep clinical expertise with entrepreneurial vision, he continues to guide international ventures through funding, regulatory pathways, and commercialization, while remaining committed to transforming cardiovascular care on a global scale.

Dr. Natalia Pinilla is an Associate Professor at the Department of Medicine Division of Cardiology at McMaster University and currently an Interventional Cardiology Staff at Hamilton Health Sciences and Niagara Health. She is the Cath Lab Director at Niagara Health and the Program Director of the Intravascular Coronary Imaging Fellowship in McMaster University. Dr. Pinilla has trained national and international interventional cardiologists in Complex Coronary Interventions and Intracoronary Imaging. She leads educational programs and academic activities worldwide; and has become a career mentor for international trainees.