Chinese expert consensus on antithrombotic management of high‐risk elderly patients with chronic coronary syndrome

• Published in: Aging medicine Vol. 6; no. 1; pp. 4 - 24
• Main Authors: Zhang, Cuntai, Wang, Xiaoming
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons, Inc 01-03-2023; John Wiley and Sons Inc; Wiley
• Subjects: Acute coronary syndromes; Anticoagulants; antithrombotic drugs; chronic coronary syndrome; coronary artery disease; Guideline; Mortality; Stents; Thromboembolism; China; coronary artery disease; antithrombotic drugs; chronic coronary syndrome
• ISSN: 2475-0360; 2475-0360
• DOI: 10.1002/agm2.12234

The prevalence and mortality of coronary artery disease (CAD) in China are still at an increasing stage. CAD can be classified as acute coronary syndrome (ACS) or chronic coronary syndrome (CCS). CCS is the main manifestation type of elderly patients with CAD, with a large number of patients, long course of disease, and poor prognosis, leading to decreased quality of life and heavy disease burden and economic burden. Especially in patients with high‐risk CCS, the case fatality rate and total mortality are high. In order to better standardize the antithrombotic treatment of elderly patients with high‐risk CCS, the Geriatrics Branch of the Chinese Medical Association organizes domestic experts to develop this consensus for clinicians' reference based on published clinical research evidence, combined with relevant guidelines, consensus, and expert recommendations in China and abroad.
Antithrombotic principles in patients with CCS: (1) Ischemic and bleeding risks should be adequately assessed to determine treatment strategies before initiating antithrombotic therapy. (2) Dual antiplatelet therapy (DAPT) or dual pathway inhibition (DPI) is recommended for patients with high ischemia risk and without high bleeding risk. (3) For CCS patients with low thrombotic risk and/or excessive bleeding risk, intensive antithrombotic therapy is suggested to avoid.