Kubica Jacek, Adamski Piotr, Buszko Katarzyna, Buszman Piotr, Elmasri Nader, Fabiszak Tomasz, Foryś Jakub, Gajda Robert, Gąsior Mariusz, Gil Robert, Grzelakowski Paweł, Hajdukiewicz Tomasz, Jaguszewski Miłosz, Kern Adam, Kochmann Wacław, Konarski Jacek, Kubica Aldona, Kudla Tobiasz, Kuliczkowski Wiktor, Kusińska-Czyczyło Aleksandra, Laskowska Ewa, Magielski Przemysław, Michalski Piotr, Milewski Krzysztof, Mrzywka Natalia, Niezgoda Piotr, Ostrowska Małgorzata, Piasecki Maciej, Podhajski Przemysław, Prokopczuk Janusz, Ratajczak Jakub, Rzepka-Cholasińska Alicja, Skonieczny Grzegorz, Specchia Giuseppe, Szarpak Łukasz, Szymański Paweł, Topolska Małgorzata, Umińska Julia M, Ziółkowski Marcin, Żurakowski Aleksander, Navarese Eliano Pio
Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
American Heart of Poland, Pila, Poland.
Cardiol J. 2025;32(3):321-327. doi: 10.5603/cj.104821. Epub 2025 May 22.
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.
根据2024年欧洲心脏病学会（ESC）慢性冠状动脉综合征管理指南，对于缺血风险增加且无高出血风险的患者，应考虑采用包括阿司匹林和第二种抗血栓药物的双重抗血栓治疗进行长期预防。然而，对于第二种抗血栓药物的选择未给出明确指征。因此，决定讨论关于此问题的现有证据。指南给出了每种推荐药物的治疗所需人数（NNT）和伤害所需人数（NNH）。然而，所呈现的数据具有误导性，可能导致不合理的治疗决策。鉴于该文件对临床实践有重大影响，应对本文件中提供的所有数据就其局限性进行仔细核实和评论。
