Novel oral anticoagulants in acute coronary syndrome.

Abstract

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide with a prevalence that has now reached pandemic levels as a consequence of the rapid modernization of the developing world. Its presentation as an acute coronary syndrome (ACS) is a frequent reason for hospital admission and of profound implications for personal, societal and global health. Despite improvements in the management of ACS with anti-platelet and anticoagulant therapy and revascularization techniques, many patients continue to suffer recurrent ischemic events. The need to reduce future cardiovascular events has led to the development of novel therapies to prevent coronary thrombosis, targeting thrombin-mediated pathways. These include direct Xa inhibitors (apixaban, rivaroxaban and darexaban), direct thrombin inhibitors (dabigatran) and PAR 1 antagonists (vorapaxar and atopaxar). This article critically reviews the comparative mechanisms of action, the risks and benefits, together with the clinical evidence base for the use of these novel oral agents in the management of ACS patients.

• Authors: Charis Costopoulos, Maria Niespialowska-Steuden, Neville Kukreja, Diana A Gorog
• Journal: International journal of cardiology (Int J Cardiol) Vol. 167 Issue 6 Pg. 2449-55 (Sep 10 2013) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 22989603 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Anticoagulants
• Benzimidazoles
• Morpholines
• Pyrazoles
• Pyridones
• Thiophenes
• beta-Alanine
• apixaban
• Rivaroxaban
• Dabigatran

Topics

• Acute Coronary Syndrome (diagnosis, drug therapy, epidemiology)
• Administration, Oral
• Animals
• Anticoagulants (administration & dosage)
• Benzimidazoles (administration & dosage)
• Dabigatran
• Humans
• Morpholines (administration & dosage)
• Pyrazoles (administration & dosage)
• Pyridones (administration & dosage)
• Randomized Controlled Trials as Topic (trends)
• Rivaroxaban
• Thiophenes (administration & dosage)
• beta-Alanine (administration & dosage, analogs & derivatives)