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  • Huber, Kurt (author)

Antiplatelet and anticoagulation agents in acute coronary syndromes : What is the current status and what does the future hold?

  • Article/chapterEnglish2014

Publisher, publication year, extent ...

  • Elsevier BV,2014
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-239381
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-239381URI
  • https://doi.org/10.1016/j.ahj.2014.06.014DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Mortality and morbidity in acute coronary syndromes (ACSs), caused principally by plaque erosion or rupture leading to thrombus formation and myocardial ischemia, have been reduced by a combination of antithrombotic agents (antiplatelet drugs and anticoagulants) and early revascularization. Aspirin is the foundation antiplatelet agent. New P2Y(12) receptor inhibitors (prasugrel and ticagrelor) have clear benefits compared with clopidogrel for dual antiplatelet therapy, and cangrelor or vorapaxar, a thrombin receptor inhibitor, may be of value in specific settings. Anticoagulation uses 1 of 4 choices: bivalirudin, unfractionated heparin, enoxaparin, and fondaparinux. Moreover, some patients (such as those who have chronic atrial fibrillation) require triple therapy with aspirin, clopidogrel, plus an anticoagulant, frequently a vitamin K antagonist. New oral anticoagulants have been shown to be at least as effective as vitamin K antagonists in atrial fibrillation and led to fewer bleeding complications. Finally, the combination of aspirin, clopidogrel, and low-dose rivaroxaban has recently been approved by the European Medicines Agency (but not the Food and Drug Administration) for secondary prevention after ACS. Several strategies have been developed to balance the potential benefit of antithrombotic therapy against the risk of bleeding complications, for example, radial access in coronary angiography or restricted use of combination therapy, and others are under investigation, such as discontinuation of aspirin. This overview summarizes the current status of antithrombotic therapy in ACS and describes strategies currently explored to optimize its benefit/risk ratio.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Bates, Eric R. (author)
  • Valgimigli, Marco (author)
  • Wallentin, LarsUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi(Swepub:uu)larswall (author)
  • Kristensen, Steen Dalby (author)
  • Anderson, Jeffrey L. (author)
  • Lopez Sendon, Jose Luis (author)
  • Tubaro, Marco (author)
  • Granger, Christopher B. (author)
  • Bode, Christoph (author)
  • Ohman, Erik Magnus (author)
  • Steg, Philippe Gabriel (author)
  • Uppsala universitetUppsala kliniska forskningscentrum (UCR) (creator_code:org_t)

Related titles

  • In:American Heart Journal: Elsevier BV168:5, s. 611-6210002-87031097-6744

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