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2020 Asian Pacific Society of Cardiology Consensus Recommendations on Antithrombotic Management for High-risk Chronic
Jack Wei Chieh Tan1,2, Derek P Chew3, David Brieger4
1National Heart Centre Singapore.
Insights
International guidelines for chronic coronary syndrome (CCS) are difficult to apply in the Asia-Pacific region. These recommendations offer tailored guidance for managing CCS patients in Asia, focusing on antithrombotic therapy.
Area of Science:
- Cardiology
- Clinical Practice Guidelines
- Asia-Pacific Healthcare
Background:
- Chronic coronary syndrome (CCS) management varies in the Asia-Pacific due to unique patient characteristics, resource disparities, and limited inclusion in global studies.
- International guidelines may not be directly applicable to diverse Asia-Pacific populations.
- There is a need for region-specific evidence-based recommendations for CCS management.
Purpose of the Study:
- To develop consensus recommendations for the assessment and management of chronic coronary syndrome (CCS) in the Asia-Pacific region.
- To provide clinicians with practical guidance tailored to local patient populations and resources.
- To address the selection of long-term antithrombotic therapy in Asian CCS patients.
Main Methods:
- An expert consensus panel reviewed and appraised existing literature, with a specific focus on data from the Asia-Pacific region.
- Consensus statements were developed based on the literature review.
- Statements were refined and finalized through an online voting process.
Main Results:
- The recommendations cover the assessment and management of both bleeding and ischaemic risks in Asian CCS patients.
- Guidance is provided on the appropriate selection of long-term antithrombotic therapies.
- Specific discussions include single antiplatelet therapy, dual antiplatelet therapy, and dual pathway inhibition therapy.
Conclusions:
- These consensus recommendations provide crucial, region-specific guidance for managing chronic coronary syndrome in the Asia-Pacific.
- The guidelines aim to improve clinical decision-making regarding antithrombotic strategies for Asian patients.
- Tailored management is essential given the unique factors influencing CCS care in this region.
Abstract:
The unique characteristics of patients with chronic coronary syndrome (CCS) in the Asia-Pacific region, heterogeneous approaches because of differences in accesses and resources and low number of patients from the Asia-Pacific region in pivotal studies, mean that international guidelines cannot be routinely applied to these populations. The Asian Pacific Society of Cardiology developed these consensus recommendations to summarise current evidence on the management of CCS and provide recommendations to assist clinicians treat patients from the region. The consensus recommendations were developed by an expert consensus panel who reviewed and appraised the available literature, with focus on data from patients in Asia-Pacific. Consensus statements were developed then put to an online vote. The resulting recommendations provide guidance on the assessment and management of bleeding and ischaemic risks in Asian CCS patients. Furthermore, the selection of long-term antithrombotic therapy is discussed, including the role of single antiplatelet therapy, dual antiplatelet therapy and dual pathway inhibition therapy.