Which antithrombin for whom? Identifying the patient population that benefits most from novel antithrombin agents.
Anticoagulation has proven to be a key component in the management of acute coronary syndromes (ACS). Pharmacological agents with various modes of action are utilized to reduce thrombus development by impairing thrombin formation, platelet activation, and platelet aggregation. The optimal management of these patients is to achieve maximal anti-ischemic benefit while avoiding bleeding complications. Synthetic "novel" agents have been developed to specifically target factor Xa or thrombin to achieve this goal. A growing amount of data show that these agents provide a net clinical benefit in the setting of stable ischemic heart disease, unstable angina, non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI).
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA.
David A
DA
Burke
Haider J
HJ
Warraich
Duane S
DS
Pinto
D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000991:Antithrombins / Q000627:therapeutic use*; D065427:Factor Xa Inhibitors; D000077425:Fondaparinux; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D018579:Patient Selection; D011134:Polysaccharides / Q000627:therapeutic use
D000991:Antithrombins; D065427:Factor Xa Inhibitors; D011134:Polysaccharides; D006493:Heparin; D000077425:Fondaparinux