Key result
Novel oral anticoagulants added to antiplatelet therapy in patients with acute coronary syndrome reduced composite ischemic events but increased the risk of major bleeding.
Answers are grounded in this paper and cite their sources.
This review summarizes the evidence for novel oral anticoagulants in ACS and discusses reasons for their limited incorporation into routine clinical practice.
The novel oral anticoagulant drugs, comprising dabigatran, rivaroxaban, and apixaban, have emerged as compelling alternatives to vitamin K antagonists for stroke prevention in atrial fibrillation, and low‑molecular‑weight heparin for thromboprophylaxis following hip and knee arthroplasty. Rivaroxaban has also been approved for treatment of venous thromboembolism. However, the role of these drugs for the management of patients with an acute coronary syndrome (ACS) is less certain. The purpose of this review was to summarize the randomized trials evaluating novel oral anticoagulants in patients with an ACS and consider the reasons why these drugs have not been incorporated into routine clinical practice. In addition, the situation involving rivaroxaban, which has been approved for use in patients with an acute coronary syndrome in Europe but not in North America, is discussed.
No takes yet. Share an insight, caveat, or question.
Liew et al. (2013) conducted a review in Acute coronary syndrome (n=31,286). Novel oral anticoagulants vs. Placebo was evaluated on Composite ischemic events (death, MI, ischemic stroke, or severe recurrent ischemia) (OR 0.86, 95% CI 0.79-0.94, p=<0.001). Novel oral anticoagulants added to antiplatelet therapy in patients with acute coronary syndrome reduced composite ischemic events but increased the risk of major bleeding.
Synapse has enriched 10 related papers. Consider them for comparative context: