title: New oral anticoagulants after acute coronary syndrome.
abstract: New oral anticoagulants (NOACs) have been developed that may further decrease the mortality and morbidity of ACS by complementing antiplatelet therapy. Optimal use of these agents can be achieved by maximum reduction in thrombotic events at the minimum bleeding risk when combining a long-term oral anticoagulant with anti-platelet therapy in patients with coronary heart disease. Although, based on the pharmacokinetics and -dynamics of NOACs, these agents could improve the current management of ACS patients, multiple trials consistently demonstrate a trend toward increased major and clinically relevant non major bleeding almost diminishing the benefits in reduction of ischemic events. Therefore, some critical issues need to be further evaluated in future trials.
authors: Department of Cardiology, St Antonius Hospital Nieuwegein, The Netherlands. n.bennaghmouch@antoniusziekenhuis.nl
authors: N
authors: N
authors: Bennaghmouch
authors: J M
authors: JM
authors: Ten Berg
mesh_terms: D054058:Acute Coronary Syndrome / Q000473:pathology / Q000517:prevention & control*; D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D000069604:Dabigatran; D065427:Factor Xa Inhibitors; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000473:pathology* / Q000517:prevention & control; D009025:Morpholines / Q000008:administration & dosage / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects*; D011728:Pyridones / Q000008:administration & dosage / Q000009:adverse effects*; D000069552:Rivaroxaban; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects*; D013917:Thrombin / Q000037:antagonists & inhibitors; D013923:Thromboembolism / Q000473:pathology / Q000517:prevention & control*; D015091:beta-Alanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D009025:Morpholines; D010975:Platelet Aggregation Inhibitors; D011720:Pyrazoles; D011728:Pyridones; D013876:Thiophenes; D015091:beta-Alanine; C522181:apixaban; D000069552:Rivaroxaban; D013917:Thrombin; D000069604:Dabigatran
keywords: acute coronary syndrome; anticoagulants; antithrombins; factor Xa; humans; secondary prevention; thrombin