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Intensified strategic competition between China and the US and the outbreak of the Russia–Ukraine conflict have polarised international attention on the promotion and prospects for European strategic autonomy (ESA). This change in the international and regional environment raises an important question: How does ESA affect China–EU relations? Answering it requires clarification of the main impacts of ESA promotion on China–EU relations. These include: the EU's reduced dependence on key materials and technologies from certain countries, and the formulation and expression, in line with core EU interests, of an independent stance and policies on China; China's adjustment of its European Strategy; and persistent external pressure from the United States. Starting from its particular interests, the EU has, to some extent, independently assessed and accordingly refined its relations with China, having pursued cooperation in global public welfare governance and other areas of similarly low ideological significance, and pragmatically explored ways of moderating competition and enhancing cooperation with China. Fields highly sensitive to geopolitical influence, or which involve key technologies and globally important supply chains, are those wherein China is treated as a competitor. Upon analysis, it can be concluded that the EU's most consistent approach to its goals of strategic autonomy is that of maintaining an alliance with the United States while avoiding full dependence on it, and competing with China in key areas that allow leeway for practical cooperation. [ABSTRACT FROM AUTHOR]

Background The evidence for the comparative effectiveness and safety of ticagrelor versus clopidogrel in older patients with acute coronary syndrome (ACS) is limited, especially in the acute phase of ACS. This study aimed to compare the in-hospital outcomes of ticagrelor versus clopidogrel in older patients with ACS. Methods Hospitalised ACS patients aged ≥75 years who were recruited to the Improving Care for Cardiovascular Disease in China-ACS project between November 2014 and December 2019 and received aspirin and P2Y12 receptor inhibitors within 24 h after first medical contact were included. The primary outcomes were in-hospital major adverse cardiovascular events (MACE) and major bleeding. Multivariable Cox regression was performed to evaluate the comparative effectiveness and safety of ticagrelor and clopidogrel. Inverse probability of treatment weighting (IPTW) and propensity score matching analyses were performed to evaluate the robustness of the results. Results Of 18,244 ACS patients, 18.5% received ticagrelor. Multivariable-adjusted analysis revealed comparable risks of in-hospital MACE between patients receiving ticagrelor and clopidogrel (hazard ratio [HR] 1.12, 95% confidence interval [CI] 0.92–1.35). However, ticagrelor use was associated with 45% higher risk of in-hospital major bleeding compared with clopidogrel use (HR 1.45, 95% CI 1.09–1.91). Similar results were found in the IPTW analysis. Conclusions ACS patients aged ≥75 years receiving ticagrelor during the acute phase had similar risk of in-hospital MACE, but higher risk of in-hospital major bleeding compared with those receiving clopidogrel. More evidence is needed to guide the use of P2Y12 receptor inhibitors during hospitalisation in older patients with ACS. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02306616. [ABSTRACT FROM AUTHOR]