Clinical use of novel antithrombotic agents in the management of acute coronary syndromes.

Journal Article (Review)

Among patients with ST elevation-acute coronary syndrome (ACS) novel thrombolytic agents can be given as a bolus (reteplase, tenecteplase) and their delivery is easier and may shorten the time to treatment, providing the ideal tool in the pre-hospital setting. Reinfarction after thrombolysis occurs in the 3-5% range in all major trials. Reinfarction after thrombolysis rate may be reduced by abciximab and enoxaparin. However major hemorrhage is doubled by abciximab (but not by enoxaparin). When primary angioplasty is preferred to thrombolysis, adjunctive abciximab decreases the need for urgent target vessel revascularization. A whole body of literature tells that aspirin is not enough in patients without ST elevation ACS. Most patients benefit from concomitant clopidogrel. High-risk patients are candidate to the use GP IIb-IIIA blockers, particularly if they need coronary angioplasty. All patients with glomerular filtration rate > or = 30 ml/min should receive low molecular weight heparin. Evidence for that is mainly driven by studies using enoxaparin.

Full Text

Duke Authors

Cited Authors

  • Melandri, G; Tricoci, P; Melloni, C; Nanni, S; Semprini, F; Fallani, F; Branzi, A

Published Date

  • September 2002

Published In

Volume / Issue

  • 32 / 5-6

Start / End Page

  • 282 - 288

PubMed ID

  • 13679658

Pubmed Central ID

  • 13679658

International Standard Serial Number (ISSN)

  • 1424-8832

Digital Object Identifier (DOI)

  • 10.1159/000073582


  • eng

Conference Location

  • Switzerland