EU survey: Even ACS patients on antiplatelet therapy at risk for cardiac events

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In Western Europe, 96 percent of physicians agree that their patients with acute coronary syndrome (ACS) on oral antiplatelet therapy (aspirin and aspirin plus ADP inhibitors, such as clopidogrel) are still at significant risk for having another cardiovascular event, according to results of a new Harris Interactive survey, sponsored by Schering-Plough.

With adverse events, such as heart attack or stroke, the majority of surveyed cardiologists estimated that up to 40 percent of these patients may be at risk.

The results of the survey, conducted among 500 cardiologists in Germany, France, Spain, Italy and the United Kingdom, were presented last week at the European Society of Cardiology (ESC) Congress 2009 in Barcelona, Spain.

“While these results reflect that cardiologists throughout Western Europe routinely use oral antiplatelet therapies to help protect their ACS patients from future events, they also demonstrate the need for greater treatment efficacy,” said Frans Van de Werf, MD, PhD, from the department of cardiology at the University of Leuven in Belgium. “Moreover, while there is a broad recognition of the residual risk these patients face, when you look at data from major ACS trials, it’s clear that the actual risk may be proportionately greater than most physicians estimate.”

While 90 percent of respondents agree that oral antiplatelet therapy is the standard-of-care treatment, 79 percent noted that some patients experience further cardiovascular events as a result of poor responses to treatment. In addition, 75 percent of cardiologists agreed somewhat or strongly that bleeding is one of the disadvantages of oral antiplatelet therapy in the treatment of ACS.

The survey also revealed that 87 percent of physicians would opt for a novel oral antiplatelet therapy that does not have incremental major bleeding risk.

“Heart disease remains the leading cause of death worldwide, and despite treatment advancements in recent years, these survey results reflect the existing concerns of cardiologists in these regions,” said Jose L. Zamorano Gomez, MD, professor of cardiology at the University Complutense in Madrid, Spain. “There is a vast unmet medical need for oral antiplatelet therapies that can address efficacy without additional incremental bleeding risk.”

To be included in the survey, cardiologists were required to: practice in the respective countries; self-report cardiology specialty; treat at least 20 patients per week; treat at least five ACS patients per week with unstable angina, STEMI or non-STEMI (with the exception of France which required three); write at least five oral antiplatelet prescriptions per month for ACS patients with unstable angina and non-STEMI and spend more than 50 percent of the time treating patients.