May I ask the authors’ views on gastro protection. Is it needed for dual or single antiplatelet agents?
Many recent articles seem to be suggesting that 1 year is not needed for dual therapy and may cause more harm than benefit compared with shorter courses (recognising that there are exceptions), and that clopidogrel may be better than aspirin as a long-term single agent. There is also only a brief mention for those with atrial fibrillation, but when should antiplatelet agents be stopped in favour of long-term use of apixaban or equivalent?
Regarding cholesterol and lipids, the UK NHS was very keen for GPs to initiate inclisaran a few years ago, possibly for commercial reasons. Here, we are advised to refer to secondary care if targets are not met. Where are we on inclisaran evidence and use?
May I also comment on Dr A Singh’s response that GP review should be incentivised for review of these patients? My view is that it is a basic core part of being a GP, and the danger is that many things are being rejected by primary care unless spelt out or separately paid for in addition to basic funding.1
- © British Journal of General Practice 2025
