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Anticoagulant agents in acute coronary syndromes

Rahul Sakhuja, Robert W Yeh, Deepak L Bhatt

    Current Problems in Cardiology
    |May 19, 2011
    PubMed

    Insights

    Novel anticoagulants show efficacy in acute coronary syndromes (ACS). This review synthesizes evidence for heparins, Factor Xa inhibitors, direct thrombin inhibitors, and oral anticoagulants in ACS management.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Thrombosis

    Background:

    • Substantial interest exists in novel antiplatelet therapies.
    • Few comprehensive reviews summarize anticoagulant data in acute coronary syndromes (ACS).
    • Up to 10% of patients with non-ST-segment elevation ACS face recurrent ischemia or death within 30 days.

    Purpose of the Study:

    • To synthesize evidence for current anticoagulants in ACS.
    • To review novel anticoagulants, including Factor Xa inhibitors and direct thrombin inhibitors.
    • To discuss oral anticoagulants and emerging agents in clinical development for ACS.

    Main Methods:

    • Literature review of large-scale trials and clinical studies.
    • Synthesis of data on heparins, Factor Xa inhibitors, and direct thrombin inhibitors.
    • Analysis of evidence for oral anticoagulants and investigational agents in ACS.

    Main Results:

    • Large-scale trials confirm the efficacy of novel procedural anticoagulants.
    • Selective Factor Xa inhibitors and direct thrombin inhibitors demonstrate effectiveness.
    • Ongoing interest in oral anticoagulants due to significant adverse events in ACS.

    Conclusions:

    • Novel anticoagulants, including Factor Xa inhibitors and direct thrombin inhibitors, are effective in ACS.
    • Further research and comprehensive reviews are needed for anticoagulants in ACS.
    • Oral anticoagulants and newer agents represent a promising area for future ACS treatment.

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