In this newsletter we would like to focus on different aspects of giving optimal antiplatelet treatment in acute coronary syndromes, atrial fibrillation and after coronary intervention. Some of the articles presented in this issue of the European Heart Journal Cardiovascular Pharmacotherapy are highlighted in the following:
Dr Feng and co-workers from Hong Kong aimed to investigate the relative safety of ticagrelor vs. clopidogrel for infection outcomes in patients with cardiovascular diseases. Randomized controlled trials (RCTs) comparing ticagrelor and clopidogrel that reported infection outcomes were included. Ten trials with 37 514 patients in total were included. The authors report that ticagrelor was associated with a lower risk of pneumonia compared with clopidogrel, although the mechanism by which ticagrelor reduces the risk of pneumonia is not known1.
Dyspnoea may occur in patients with acute coronary syndrome (ACS) treated with ticagrelor compared with other antiplatelet agents. Central apnoeas are a likely mechanism of dyspnoea and should be screened for in patients treated with ticagrelor. A drug-related sensitization of the chemoreflex may be the cause of ventilatory instability and breathlessness in this setting2.
De novo atrial fibrillation during myocardial infarction was shown by Hofer at al. to be independently associated with a poor prognosis with a 67% increased risk of long-term cardiovascular mortality. Intensified anti-thrombotic treatment in this high-risk patient population is advocated to be considered3.
Aspirin-omitted dual antithrombotic treatment reduces the occurrence of bleeding episodes, with a higher rate of myocardial infarction and stent thrombosis in non-valvular atrial fibrillation patients presenting with acute coronary syndrome or undergoing PCI4.
In Pharmapulse section of this issue of the of the European Heart Journal Cardiovascular Pharmacotherapy professor G. Savarese has elegantly summarized new evidence from the scientific sessions 2020 of the American Heart Association5.
Regarding educational activities and conferences, we have due to the corona pandemic successfully changed the formats to online meetings regarding the "All About Clinical Trials" (AACT)[December 2021], Pharmacotherapy in Older People (POP)[October 2021] and EuroCVP, 10-12 June 2021. We will launch a new educational programme early 2022 termed “Cardiovascular Pharmacotherapy in Women”. Detailed information regarding programmes, dates etc. is accessible here.
On behalf of the Working Group Nucleus,
Alexander Niessner, Chairperson 2020-2022 and
Anne Grete Semb, Communication Coordinator 2020-2022