Antithrombotic treatment of acute coronary syndromes.
This article provides a brief review of the coagulation process and an overview of the different antithrombotic treatment strategies that are available or being developed for the management of acute coronary syndromes. Active antithrombotic agents belong to three general classes: thrombolytic agents, anticoagulants and antiplatelet drugs. Thrombolytic agents are life-saving in acute myocardial infarction with ST segment elevation, but they are not useful and possibly harmful in other acute coronary syndromes. Anticoagulants are very effective during the acute phase, but their benefit is limited by reactivation of the disease following their discontinuation. Antiplatelet therapy with acetylsalicylic acid is useful during the acute, subacute and more chronic phases of acute coronary syndromes. The future is rich in treatment opportunities with the availability of a new generation of anticoagulants (e.g., low molecular weight heparins) and of antiplatelet agents (i.e., glycoprotein IIb/IIIa inhibitors).
Théroux
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Department of Medicine, Montreal Heart Institute, University of Montreal, Quebec. theroux@icm.umontreal.ca
D000208:Acute Disease; D000789:Angina, Unstable / Q000188:drug therapy; D000925:Anticoagulants / Q000627:therapeutic use*; D003327:Coronary Disease / Q000188:drug therapy*; D003328:Coronary Thrombosis / Q000188:drug therapy*; D006801:Humans; D013577:Syndrome
D000925:Anticoagulants