Extended dual antithrombotic therapy in patients with chronic coronary syndrome - which agent should be added to aspirin?

Cardiology journal Pub Date : 2025-01-01 Epub Date: 2025-05-22 DOI:10.5603/cj.104821

Jacek Kubica, Piotr Adamski, Katarzyna Buszko, Piotr Buszman, Nader Elmasri, Tomasz Fabiszak, Jakub Foryś, Robert Gajda, Mariusz Gąsior, Robert Gil, Paweł Grzelakowski, Tomasz Hajdukiewicz, Miłosz Jaguszewski, Adam Kern, Wacław Kochmann, Jacek Konarski, Aldona Kubica, Tobiasz Kudla, Wiktor Kuliczkowski, Aleksandra Kusińska-Czyczyło, Ewa Laskowska, Przemysław Magielski, Piotr Michalski, Krzysztof Milewski, Natalia Mrzywka, Piotr Niezgoda, Małgorzata Ostrowska, Maciej Piasecki, Przemysław Podhajski, Janusz Prokopczuk, Jakub Ratajczak, Alicja Rzepka-Cholasińska, Grzegorz Skonieczny, Giuseppe Specchia, Łukasz Szarpak, Paweł Szymański, Małgorzata Topolska, Julia M Umińska, Marcin Ziółkowski, Aleksander Żurakowski, Eliano Pio Navarese

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Abstract

According to the 2024ESC Guidelines for the management of chronic coronary syndromes dual antithrombotic treatment comprising aspirin and a second antithrombotic drug for extended long-term prevention should be considered in patients at increased ischemic risk without high bleeding risk. However, no clear indications regarding the choice of a second antithrombotic agent are provided. It was therefore decided to discuss the available evidence regarding this issue. The guidelines provided the number needed to treat (NNT) and the number needed to harm (NNH) for each proposed medication. However, the presented data are misleading and may result in unjustified therapeutic decisions. Due to the great impact of this document on clinical practice all data provided in this document should be carefully verified and commented regarding limitations.

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慢性冠状动脉综合征患者延长双重抗血栓治疗-哪一种药物应该加入阿司匹林？

根据2024ESC慢性冠状动脉综合征管理指南，对于缺血风险增加但无高出血风险的患者，应考虑采用双重抗血栓治疗，包括阿司匹林和第二种抗血栓药物，用于长期预防。然而，关于第二种抗血栓药物的选择没有明确的适应症。因此，决定讨论关于这个问题的现有证据。该指南为每种建议的药物提供了治疗所需数量（NNT）和危害所需数量（NNH）。然而，目前的数据具有误导性，并可能导致不合理的治疗决定。由于本文件对临床实践的巨大影响，本文件中提供的所有数据都应仔细验证并评论其局限性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Cardiology journal

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