title: The need for novel anticoagulation therapy in acute coronary syndrome.
abstract: As acute coronary syndrome (ACS) becomes more common nationwide and current anticoagulation regimens used in patients with ACS continue to possess their shortcomings, the need for new anticoagulants is on the rise. Although heparin and warfarin are used effectively in patients with ACS, they both have significant side effects and delivery issues. New factor Xa inhibitors offer an oral alternative that functions early in the coagulation cascade. The role of these new drugs in ACS is explored here. Electronic search strategies were used to collect reviews, randomized controlled trials, and other studies. Databases used included Medline and Cochrane Library and hand selection. Sources selected were limited to those that discussed factor Xa inhibitors in the context of ACS. Selected studies were then assessed for quality and relevance and those deemed relevant included for analysis. Some of the factor Xa inhibitors such as rivaroxaban offer anticoagulation as effective as, if not more effective, heparin and warfarin with lower risks of bleeding and other adverse effects such as heparin-induced thrombocytopenia. Many of these new agents also come in oral form, making them easy for patients to manage and use daily.
authors.affiliation: Chicago Medical School,North Chicago, IL, USA.
authors.forename: Suraj
authors.initials: S
authors.lastname: Chandrasekar
authors.forename: Rohit
authors.initials: R
authors.lastname: Loomba
authors.forename: Parinda
authors.initials: P
authors.lastname: Shah
authors.forename: Rohit
authors.initials: R
authors.lastname: Arora
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000201:enzymology; D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D003497:Cyclic N-Oxides / Q000627:therapeutic use; D065427:Factor Xa Inhibitors; D000077425:Fondaparinux; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D009025:Morpholines / Q000627:therapeutic use; D009281:Naphthalenes / Q000627:therapeutic use; D011134:Polysaccharides / Q000627:therapeutic use; D011422:Propionates / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011728:Pyridones / Q000627:therapeutic use; D000069552:Rivaroxaban; D013876:Thiophenes / Q000627:therapeutic use; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: C086910:(2S)-2-(4-(((3S)-1-acetimidoyl-3-pyrrolidinyl)oxy)phenyl)-3-(7-amidino-2-naphtyl)propanoic acid; D000925:Anticoagulants; D003497:Cyclic N-Oxides; D065427:Factor Xa Inhibitors; D009025:Morpholines; D009281:Naphthalenes; D011134:Polysaccharides; D011422:Propionates; D011720:Pyrazoles; D011725:Pyridines; D011728:Pyridones; D013876:Thiophenes; C522181:apixaban; D014859:Warfarin; D006493:Heparin; D000069552:Rivaroxaban; D000077425:Fondaparinux; C435830:otamixaban