title: [Contribution of the new oral anticoagulants to the treatment of acute coronary syndrome].
abstract: Acute coronary syndrome (ACS) occurs as a result of atherosclerotic plaque rupture and subsequent platelet activation and coagulation leading to thrombus formation and coronary occlusion. Thrombin and activated factor X (FXa) are key elements in the coagulation cascade. The use of anticoagulants in ACS, both in the acute phase and in the long term, has improved prognosis by reducing thrombotic events, but is associated with an increased risk of bleeding. In recent years, new oral anticoagulants have been developed that do not require monitoring and produce a lower risk of bleeding. Rivaroxaban is the only drug with a favorable risk-benefit profile in patients with ACS. The ATLAS ACS TIMI 2-51 is the first phase III trial demonstrating that the addition of low-dose rivaroxaban to optimal antiplatelet therapy reduces mortality, cardiovascular mortality, infarct or stroke without significantly increasing fatal bleeding.
authors.affiliation: Servicio de Cardiología, Institut Clínic del Tòrax, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España.
authors.forename: Diego
authors.initials: D
authors.lastname: Fernández
authors.forename: Diego
authors.initials: D
authors.lastname: Penela
authors.forename: Magda
authors.initials: M
authors.lastname: Heras
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D001381:Azepines / Q000627:therapeutic use; D001384:Azetidines / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D001596:Benzylamines / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D000069604:Dabigatran; D004334:Drug Administration Schedule; D006801:Humans; D009025:Morpholines / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D011728:Pyridones / Q000627:therapeutic use; D000069552:Rivaroxaban; D013876:Thiophenes / Q000627:therapeutic use; D015091:beta-Alanine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001381:Azepines; D001384:Azetidines; D001549:Benzamides; D001562:Benzimidazoles; D001596:Benzylamines; D009025:Morpholines; D011720:Pyrazoles; D011728:Pyridones; D013876:Thiophenes; D015091:beta-Alanine; C522181:apixaban; C426686:ximelagatran; D000069552:Rivaroxaban; D000069604:Dabigatran; C569750:darexaban