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Novel oral anticoagulants after acute coronary syndromes.

Publication ,  Journal Article
Wiggins, NB; Granger, CB; Alexander, JH
Published in: Cardiovasc Drugs Ther
June 2012

PURPOSE: A number of novel oral anticoagulants, including direct thrombin inhibitors and direct factor Xa inhibitors, have been developed. This review discusses these agents and their respective clinical trials in patients with acute coronary syndromes. METHODS: This review discusses the results of phase 2 and 3 clinical trials with novel oral anticoagulants. RESULTS: Phase 2 clinical trials demonstrated that novel oral anticoagulants increase the risk of bleeding in a dose-related fashion, particularly when used in addition to dual antiplatelet therapy. What was less clear is their impact on recurrent ischemic events. In phase 3 trials, rivaroxaban was found to have a benefit on ischemic events and perhaps a greater benefit at the lower dose. The phase 3 trial with apixaban was stopped early due to increased bleeding without a meaningful reduction in ischemic events. CONCLUSIONS: Novel oral anticoagulants represent a promising, potentially beneficial treatment for patients with a recent acute coronary syndrome but come with a risk of bleeding. The benefits and risks of these agents will need to be carefully weighed and may depend on both patient risk and concomitant therapy. Additional research is needed to determine how to best integrate these medications into the care of patients with acute coronary syndromes.

Duke Scholars

Published In

Cardiovasc Drugs Ther

DOI

EISSN

1573-7241

Publication Date

June 2012

Volume

26

Issue

3

Start / End Page

265 / 271

Location

United States

Related Subject Headings

  • Platelet Aggregation Inhibitors
  • Humans
  • Cardiovascular System & Hematology
  • Anticoagulants
  • Administration, Oral
  • Acute Coronary Syndrome
  • 3214 Pharmacology and pharmaceutical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1115 Pharmacology and Pharmaceutical Sciences
 

Citation

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Wiggins, N. B., Granger, C. B., & Alexander, J. H. (2012). Novel oral anticoagulants after acute coronary syndromes. Cardiovasc Drugs Ther, 26(3), 265–271. https://doi.org/10.1007/s10557-012-6386-0
Wiggins, Newton B., Christopher B. Granger, and John H. Alexander. “Novel oral anticoagulants after acute coronary syndromes.Cardiovasc Drugs Ther 26, no. 3 (June 2012): 265–71. https://doi.org/10.1007/s10557-012-6386-0.
Wiggins NB, Granger CB, Alexander JH. Novel oral anticoagulants after acute coronary syndromes. Cardiovasc Drugs Ther. 2012 Jun;26(3):265–71.
Wiggins, Newton B., et al. “Novel oral anticoagulants after acute coronary syndromes.Cardiovasc Drugs Ther, vol. 26, no. 3, June 2012, pp. 265–71. Pubmed, doi:10.1007/s10557-012-6386-0.
Wiggins NB, Granger CB, Alexander JH. Novel oral anticoagulants after acute coronary syndromes. Cardiovasc Drugs Ther. 2012 Jun;26(3):265–271.
Journal cover image

Published In

Cardiovasc Drugs Ther

DOI

EISSN

1573-7241

Publication Date

June 2012

Volume

26

Issue

3

Start / End Page

265 / 271

Location

United States

Related Subject Headings

  • Platelet Aggregation Inhibitors
  • Humans
  • Cardiovascular System & Hematology
  • Anticoagulants
  • Administration, Oral
  • Acute Coronary Syndrome
  • 3214 Pharmacology and pharmaceutical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1115 Pharmacology and Pharmaceutical Sciences