[Use of parenteral anticoagulants in patients with coronary syndrome]

Area of Science:

• Cardiology
• Pharmacology

Background:

• Anticoagulant and antiplatelet therapy are crucial for acute coronary syndromes (ACS), reducing ischemic events, stent thrombosis, and mortality.
• Clinical practice shows significant heterogeneity in anticoagulant use for ACS, potentially leading to suboptimal patient outcomes.

Approach:

• This paper presents a narrative review of parenteral anticoagulant use in ACS.
• It analyzes anticoagulant strategies based on clinical scenarios, revascularization methods, and bleeding risk.
• Updated evidence for anticoagulant regimens in ST-elevation and non-ST-elevation ACS is discussed.

Key Points:

• Heterogeneity in current anticoagulant practices for ACS necessitates evidence-based guidance.
• Tailoring anticoagulant therapy to clinical context, revascularization strategy, and bleeding risk is essential.
• Updated evidence supports specific anticoagulant schemes for different ACS presentations.

Conclusions:

• Optimizing parenteral anticoagulant therapy in ACS requires careful consideration of individual patient factors and clinical presentation.
• Evidence-based risk stratification for bleeding and tailored therapeutic management are critical for improving ACS treatment.
• Standardizing anticoagulant use based on updated evidence can enhance treatment efficacy and patient safety.