New antithrombotic agents: are they needed and what can they offer to patients with a non-ST-elevation acute coronary syndrome?
Antithrombotic therapy is a cornerstone of treatment for non-ST-segment elevation acute coronary syndromes, as demonstrated in numerous clinical trials. Long-term oral antiplatelet therapy targeting specific platelet activation pathways has demonstrated significant long-term benefits, whereas antithrombin use is limited to the acute setting. Despite proven efficacy of long-term dual oral antiplatelet therapy with aspirin and clopidogrel, residual morbidity and mortality is considerable. This may be partly due to incomplete inhibition of platelet activation with current agents and/or lack of long-term anticoagulant therapy. Improvements in patient outcomes could be achieved by developing agents that inhibit other platelet activation pathways or by adding new anticoagulants such as oral anti-IIa or anti-Xa agents for a prolonged period of time after the acute event. This review describes the rationale behind and the current status of the trials with new antithrombotic agents.
Van de Werf
Frans
F
Department of Cardiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. frans.vandewerf@uz.kuleuven.ac.be
D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000401:mortality; D000925:Anticoagulants / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects*; D017410:Practice Guidelines as Topic
D000925:Anticoagulants; D005343:Fibrinolytic Agents