title: Oral anticoagulant use in addition to antiplatelet therapy for secondary prevention in acute coronary syndrome: current perspectives.
abstract: Patients with acute coronary syndrome (ACS) are typically managed with long-term dual antiplatelet therapy of acetylsalicylic acid plus a P2Y12 platelet receptor antagonist; however, although effective, the risk of another vascular event within 12 months remains at approximately 10%. Considerable efforts have been made to find improved therapeutic approaches to secondary prevention in ACS. The ATLAS ACS 2-TIMI 51 trial demonstrated that rivaroxaban (2.5 mg twice daily) significantly reduced recurrent vascular events, increased the risk of major bleeding but not the risk of fatal bleeding, and resulted in reduced rates of death from cardiovascular causes. These results formed the basis for approval in Europe of rivaroxaban (2.5 mg twice daily) in conjunction with standard antiplatelet therapy for the secondary prevention of ACS.
authors.affiliation: Hamilton Health Sciences-General Hospital, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2 Canada.
authors.forename: Alexander G G
authors.initials: AG
authors.lastname: Turpie
mesh_terms: D054058:Acute Coronary Syndrome / Q000517:prevention & control*; D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017277:Drug Approval; D004359:Drug Therapy, Combination; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D009025:Morpholines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069552:Rivaroxaban; D055502:Secondary Prevention / Q000379:methods; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D009025:Morpholines; D010975:Platelet Aggregation Inhibitors; D013876:Thiophenes; D000069552:Rivaroxaban
keywords: acute coronary syndrome; apixaban; clopidogrel; dabigatran; prasugrel; rivaroxaban; ticagrelor; vorapaxar; warfarin