This review discusses the limitations of aspirin and unfractionated heparin and explores new antithrombotic agents for acute coronary ischemic syndromes and percutaneous coronary revascularization.
Highlights limitations of aspirin and heparin in ACS; leaves open the role of novel antithrombotics pending randomized trials.
Many of the acute coronary ischemic syndromes are triggered by spontaneous or mechanical disruption of atherosclerotic plaques with resultant activation of platelets and coagulation. Given the central role of platelets and thrombin in arterial thrombosis, current strategies for its prevention and treatment focus on both inhibition of platelet aggregation and control of thrombin generation and activity. Although aspirin and unfractionated heparin are the cornerstones of current treatment strategies, both have limitations. This review will describe these limitations and discuss new antithrombotic agents developed for use in acute coronary ischemic syndromes and as adjuncts for percutaneous coronary revascularization procedures.
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Stewart Bates (1999) studied this question.
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