New anticoagulant strategies in ST elevation myocardial infarction: trials and clinical implications.
New data have re-established the importance of anticoagulation of patients with ST segment elevation myocardial infarction (STEMI), both as an adjuvant to reperfusion therapy or in patients ineligible for reperfusion. Recent randomized trials have found newer agents to be superior to conventional unfractionated heparin. This article summarizes current understanding of the underlying pathophysiology of STEMI and provides a comprehensive review of emerging trial data for low molecular weight heparins, anti-factor Xa agents and direct thrombin inhibitors in this setting.
McCann
Conor J
CJ
Craigavon Cardiac Centre, Craigavon Area Hospital, Craigavon, Northern Ireland, UK.
Menown
Ian B A
IB
D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D002986:Clinical Trials as Topic; D065427:Factor Xa Inhibitors; D000077425:Fondaparinux; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D010446:Peptide Fragments / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011134:Polysaccharides / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D013917:Thrombin / Q000037:antagonists & inhibitors; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D006495:Heparin, Low-Molecular-Weight; D006629:Hirudins; D010446:Peptide Fragments; D010975:Platelet Aggregation Inhibitors; D011134:Polysaccharides; D011994:Recombinant Proteins; D013917:Thrombin; D000077425:Fondaparinux; C074619:bivalirudin