[Oral anticoagulants combined with aspirin in the prolonged treatment after acute coronary syndrome].
The incidence of death or myocardial infarction after acute coronary syndrome (ACS) is still high despite the widespread use of aspirin. Oral anticoagulant therapy (OAT) reducing thrombin activity has the potential to be beneficial when administered alone or in combination with aspirin after ACS. Low-intensity OAT in combination with aspirin is not superior to aspirin alone. Moderate-intensity OAT in combination with aspirin is superior to aspirin alone in reducing death, myocardial infarction or stroke after ACS. However, this regimen has higher rates of both minor and major hemorrhages. The bleeding risk combined with the difficulties of OAT management contributes to suboptimal compliance and has the potential to mitigate the superior efficacy of combined regimens.
Di Pasquale
Giuseppe
G
U.O. di Cardiologia, Azienda USL Bologna Nord, Ospedale di Bentivoglio, Via Marconi, 35, 40010 Bentivoglio, BO. g.dipa@libero.it
Biancoli
Stefano
S
Cerè
Elisabetta
E
Parlangeli
Riccardo
R
D000208:Acute Disease; D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001241:Aspirin / Q000627:therapeutic use*; D003327:Coronary Disease / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D013577:Syndrome; D013997:Time Factors
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D001241:Aspirin
Associazione di anticoagulanti orali e aspirina in trattamento prolungato dopo sindrome coronarica acuta.