Antithrombotic therapy in patients with acute coronary syndrome: similarities and differences between a European expert consensus document and the 2023 European Society of Cardiology guidelines

Author:

Landi Antonio12,Aboyans Victor3ORCID,Angiolillo Dominick J4,Atar Dan5ORCID,Capodanno Davide6ORCID,Fox Keith A A7,Halvorsen Sigrun89,James Stefan10ORCID,Jüni Peter11,Leonardi Sergio12ORCID,Mehran Roxana13ORCID,Montalescot Gilles14,Navarese Eliano Pio15,Niebauer Josef16ORCID,Oliva Angelo17,Piccolo Raffaele18,Price Susanna19ORCID,Storey Robert F20,Völler Heinz21ORCID,Vranckx Pascal22ORCID,Windecker Stephan23ORCID,Valgimigli Marco1224ORCID

Affiliation:

1. Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute , Tesserete, 48 . CH-6900, Lugano, Switzerland

2. Department of Biomedical Sciences, University of Italian Switzerland , Lugano , Switzerland

3. Department of Cardiology, Dupuytren University Hospital, and INSERM 1094 & IRD, University of Limoges , 2, Martin Luther King Ave , 87042, Limoges, France

4. Division of Cardiology, University of Florida College of Medicine-Jacksonville , 655 West 8th Street , Jacksonville, FL 32209, USA

5. Oslo University Hospital Ulleval, Department of Cardiology, and Institute of Clinical Medicine, University of Oslo , Oslo , Norway

6. Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico ‘G. Rodolico-San Marco’, University of Catania , Via Santa Sofia, 78 , Catania 95123, Italy

7. Centre for Cardiovascular Science, University of Edinburgh Division of Clinical and Surgical Sciences , Edinburgh, UK

8. Institute of Clinical Medicine, University of Oslo , Blindern, P.O. Box 1078 , N-0316, Oslo, Norway

9. Department of Cardiology, Oslo University Hospital Ulleval , Oslo , Norway

10. Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University , Uppsala 751 85 , Sweden

11. Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford , Oxford , UK

12. University of Pavia and Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy

13. Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , NY, NewYork , USA

14. ACTION Group, INSERM UMRS 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université , Paris , France

15. Clinical Experimental Cardiology, Department of Clinical Interventional Cardiology, University of Sassari , Sassari, Sardinia Island , Italy

16. University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg , 5020 Salzburg , Austria

17. Department of Biomedical Sciences, Humanitas University , 20090 Pieve Emanuele-Milan , Italy

18. Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II , Naples , Italy

19. Royal Brompton Hospital, National Heart and Lung Institute, Imperial College , London , UK

20. Cardiovascular Research Unit, Division of Clinical Medicine, University of Sheffield , Sheffield , UK

21. Department of Rehabilitation Medicine, Faculty of Health Science Brandenburg, University of Potsdam , Potsdam , Germany

22. Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, and Faculty of Medicine and Life Sciences, Hasselt University , Hasselt , Belgium

23. Department of Cardiology, Inselspital, University of Bern , Bern , Switzerland

24. University of Bern , Bern , Switzerland

Abstract

Abstract Antithrombotic therapy represents the cornerstone of the pharmacological treatment in patients with acute coronary syndrome (ACS). The optimal combination and duration of antithrombotic therapy is still matter of debate requiring a critical assessment of patient comorbidities, clinical presentation, revascularization modality, and/or optimization of medical treatment. The 2023 European Society of Cardiology (ESC) guidelines for the management of patients with ACS encompassing both patients with and without ST segment elevation ACS have been recently published. Shortly before, a European expert consensus task force produced guidance for clinicians on the management of antithrombotic therapy in patients with ACS as well as chronic coronary syndrome. The scope of this manuscript is to provide a critical appraisal of differences and similarities between the European consensus paper and the latest ESC recommendations on oral antithrombotic regimens in ACS patients.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Critical Care and Intensive Care Medicine,General Medicine

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