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Current Cardiology Reports

, Volume 14, Issue 4, pp 493–501 | Cite as

Which Antithrombin for Whom? Identifying the Patient Population that Benefits Most from Novel Antithrombin Agents

  • David A. Burke
  • Haider J. Warraich
  • Duane S. PintoEmail author
Management of Acute Coronary Syndromes (R Mehran, Section Editor)

Abstract

Anticoagulation has proven to be a key component in the management of acute coronary syndromes (ACS). Pharmacological agents with various modes of action are utilized to reduce thrombus development by impairing thrombin formation, platelet activation, and platelet aggregation. The optimal management of these patients is to achieve maximal anti-ischemic benefit while avoiding bleeding complications. Synthetic “novel” agents have been developed to specifically target factor Xa or thrombin to achieve this goal. A growing amount of data show that these agents provide a net clinical benefit in the setting of stable ischemic heart disease, unstable angina, non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI).

Keywords

Anticoagulation Factor Xa inhibitor Thrombin inhibitor Heparin Fondaparinux Apixaban Rivaroxaban Bivalirudin Argatroban Unstable angina NSTEMI STEMI Antithrombin 

Notes

Disclosure

Conflicts of interest: D.A. Burke: none; H.J. Warraich: none; D.S. Pinto: has been a consultant for Medicines Company, Janssen, AstraZeneca, Merck, and Genentech.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • David A. Burke
    • 1
  • Haider J. Warraich
    • 1
  • Duane S. Pinto
    • 1
    • 2
    Email author
  1. 1.Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonUSA
  2. 2.Division of CardiologyBeth Israel Deaconess Medical CenterBostonUSA

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