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

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...

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Main Authors: 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
Format: Article
Language:English
Published: Via Medica 2025-06-01
Series:Cardiology Journal
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Online Access:https://journals.viamedica.pl/cardiology_journal/article/view/104821
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author 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
author_facet 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
author_sort Jacek Kubica
collection DOAJ
description 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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publishDate 2025-06-01
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record_format Article
series Cardiology Journal
spelling doaj-art-8b5008eeca8d4e1a9dd01250069dd4842025-08-21T06:14:13ZengVia MedicaCardiology Journal1897-55931898-018X2025-06-0132310.5603/cj.104821Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?Jacek Kubica0Piotr Adamski1Katarzyna Buszko2Piotr Buszman3Nader Elmasri4Tomasz Fabiszak5Jakub Foryś6Robert Gajda7Mariusz Gąsior8Robert Gil9Paweł Grzelakowski10Tomasz Hajdukiewicz11Miłosz Jaguszewski12Adam Kern13Wacław Kochmann14Jacek Konarski15Aldona Kubica16Tobiasz Kudla17Wiktor Kuliczkowski18Aleksandra Kusińska-Czyczyło19Ewa Laskowska20Przemysław Magielski21Piotr Michalski22Krzysztof Milewski23Natalia Mrzywka24Piotr Niezgoda25https://orcid.org/0000-0002-9912-9730Małgorzata Ostrowska26Maciej Piasecki27Przemysław Podhajski28Janusz Prokopczuk29Jakub Ratajczak30Alicja Rzepka-Cholasińska31Grzegorz Skonieczny32Giuseppe Specchia33Łukasz Szarpak34Paweł Szymański35Małgorzata Topolska36Julia M. Umińska37Marcin Ziółkowski38Aleksander Żurakowski39Eliano Pio Navarese40Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCentre for Cardiovascular Research and Development of American Heart of Poland, Katowice, Gruppo San Donato, Katowice PolandAmerican Heart of Poland, Sztum, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandAmerican Heart of Poland, Zgierz, PolandModern Medical Technologies Center, Torun, Poland3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, PolandDepartment of Cardiology, National Institute of Medicine Ministry of the Internal Affairs and Administration, Warsaw, PolandDepartment of Cardiology and Cardiac Surgery, 10th Military Hospital and Polyclinic, Bydgoszcz, PolandDepartment of Cardiology, Provincial Hospital of Elblag, Poland1st Department of Cardiology, Medical University of Gdansk, Gdansk, PolandDepartment of Cardiology and Internal Medicine, University of Warmia and Mazury in Olsztyn, PolandDepartment of Cardiovascular Disease, Centre of Postgraduate Medical Education, Warsaw, PolandAmerican Heart of Poland, Pila, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandAmerican Heart of Poland, Kedzierzyn-Kozle, PolandClinical Department of Cardiology, Department of Cardiology, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical UniversityAmerican Heart of Poland, Kedzierzyn-Kozle, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandScientia Research Institute, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandAmerican Heart of Poland, Bielsko-Biala, PolandAmerican Heart of Poland, Pila, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandAmerican Heart of Poland, Kedzierzyn-Kozle, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandClinical Department of Cardiology, The Ludwik Rydygier Provincial Polyclinical Hospital, Torun, PolandProfesor emeritus, Department of Cardiology, University of Pavia, ItalyDepartment of Clinical Research and Development, LUXMED Group, Warsaw, PolandRegional Specialistic Hospital, Grudziadz, PolandAmerican Heart of Poland, Katowice, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandCollegium Medicum, Nicolaus Copernicus University, Bydgoszcz, PolandAndrzej Frycz Modrzewski Krakow University, PolandClinical Experimental Cardiology, Clinical and Interventional Cardiology, University of Sassari, Sassari, Sardinia Island, ItalyAccording 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.https://journals.viamedica.pl/cardiology_journal/article/view/104821extended antithrombotic therapychronic coronary syndromerivaroxabanticagrelorclopidogrelprasugrel
spellingShingle 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
Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?
Cardiology Journal
extended antithrombotic therapy
chronic coronary syndrome
rivaroxaban
ticagrelor
clopidogrel
prasugrel
title Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?
title_full Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?
title_fullStr Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?
title_full_unstemmed Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?
title_short Extended dual antithrombotic therapy in patients with chronic coronary syndrome — which agent should be added to aspirin?
title_sort extended dual antithrombotic therapy in patients with chronic coronary syndrome which agent should be added to aspirin
topic extended antithrombotic therapy
chronic coronary syndrome
rivaroxaban
ticagrelor
clopidogrel
prasugrel
url https://journals.viamedica.pl/cardiology_journal/article/view/104821
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