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Antiplatelets in acute coronary syndrome in Poland - from guidelines to clinical practice

Stanisław Tubek1, Wiktor Kuliczkowski2, Mariusz Gąsior3

  • 1Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.

Postepy W Kardiologii Interwencyjnej = Advances in Interventional Cardiology
|August 17, 2021
PubMed

Insights

Optimal antiplatelet therapy is crucial for acute coronary syndrome (ACS) patients to reduce cardiovascular events. However, real-world data shows poor adherence to guidelines in Poland, necessitating immediate improvements in care.

Area of Science:

  • Cardiology
  • Clinical Practice Guidelines
  • Pharmacotherapy

Background:

  • Acute coronary syndrome (ACS) significantly increases the risk of poor prognosis and recurrent cardiovascular events.
  • Effective antiplatelet therapy is essential for risk reduction in ACS patients.
  • European Society of Cardiology guidelines provide detailed recommendations for antiplatelet use in ST-elevation and non-ST-elevation myocardial infarction.

Purpose of the Study:

  • To conduct a comprehensive review of antiplatelet therapy in acute coronary syndrome (ACS).
  • To analyze adherence to guideline-recommended antiplatelet treatment in Poland using real-world data.
  • To identify areas for improvement in the management of ACS patients.

Main Methods:

  • Review of European Society of Cardiology guidelines on antiplatelet therapy.
  • Analysis of unpublished data from Polish registries (PL-ACS 2019, National Registry of Procedures of Invasive Cardiology, RECEPTOmetrPEX panel).
  • Discussion of antiplatelet use across pre-hospital, in-hospital, and post-hospital phases of ACS treatment.

Main Results:

  • Real-world data from Polish registries indicates suboptimal adherence to recommended antiplatelet treatments for ACS.
  • Significant discrepancies exist between guideline recommendations and actual clinical practice in Poland.
  • Specific areas requiring immediate improvement in patient care have been identified.

Conclusions:

  • Individualized assessment of ischemic and bleeding risk is paramount for tailoring antiplatelet therapy in ACS.
  • Repeated risk assessment throughout treatment phases is crucial for optimizing patient outcomes.
  • Improving adherence to evidence-based antiplatelet strategies is critical for enhancing ACS management in Poland.

Keywords:
ST elevation myocardial infarctionantiplatelet treatmentguidelinesnon-ST elevation myocardial infarction

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