Dual Pathway Inhibition with Low-Dose Direct Factor Xa Inhibition after Acute Coronary Syndromes-Why Is It Not Used in Clinical Practice?
Standard
Dual Pathway Inhibition with Low-Dose Direct Factor Xa Inhibition after Acute Coronary Syndromes-Why Is It Not Used in Clinical Practice? / Zeymer, Uwe; Schrage, Benedikt; Westermann, Dirk.
In: THROMB HAEMOSTASIS, Vol. 118, No. 9, 09.2018, p. 1528-1534.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Dual Pathway Inhibition with Low-Dose Direct Factor Xa Inhibition after Acute Coronary Syndromes-Why Is It Not Used in Clinical Practice?
AU - Zeymer, Uwe
AU - Schrage, Benedikt
AU - Westermann, Dirk
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2018/9
Y1 - 2018/9
N2 - The optimal anti-thrombotic therapy for secondary prevention after an acute coronary syndrome is still a matter of debate. While current guidelines recommend dual anti-platelet therapy with aspirin and a P2Y12 inhibitor over 12 months especially in patients with stent implantation, the value of prolonged anticoagulation is still controversial. In the ATLAS-TIMI 52 trial, a low-dose direct factor Xa inhibition with rivaroxaban compared with placebo reduced the combined primary endpoint of cardiovascular mortality, myocardial infraction and stroke with an increase in major bleeding complications. This article discusses the value and problems of adding low-dose rivaroxaban to anti-platelet therapy as secondary prevention measure after an acute myocardial infarction. It will describe the pros and cons of intensified anti-platelet therapy versus dual pathway inhibition and give recommendations for different patient groups in clinical practice.
AB - The optimal anti-thrombotic therapy for secondary prevention after an acute coronary syndrome is still a matter of debate. While current guidelines recommend dual anti-platelet therapy with aspirin and a P2Y12 inhibitor over 12 months especially in patients with stent implantation, the value of prolonged anticoagulation is still controversial. In the ATLAS-TIMI 52 trial, a low-dose direct factor Xa inhibition with rivaroxaban compared with placebo reduced the combined primary endpoint of cardiovascular mortality, myocardial infraction and stroke with an increase in major bleeding complications. This article discusses the value and problems of adding low-dose rivaroxaban to anti-platelet therapy as secondary prevention measure after an acute myocardial infarction. It will describe the pros and cons of intensified anti-platelet therapy versus dual pathway inhibition and give recommendations for different patient groups in clinical practice.
KW - Acute Coronary Syndrome/drug therapy
KW - Acute Disease
KW - Anticoagulants/therapeutic use
KW - Aspirin/therapeutic use
KW - Clinical Trials as Topic
KW - Drug Therapy, Combination
KW - Factor Xa Inhibitors/therapeutic use
KW - Humans
KW - Myocardial Infarction/drug therapy
KW - Practice Guidelines as Topic
KW - Purinergic P2Y Receptor Antagonists/therapeutic use
KW - Rivaroxaban/therapeutic use
U2 - 10.1055/s-0038-1668133
DO - 10.1055/s-0038-1668133
M3 - SCORING: Review article
C2 - 30103248
VL - 118
SP - 1528
EP - 1534
JO - THROMB HAEMOSTASIS
JF - THROMB HAEMOSTASIS
SN - 0340-6245
IS - 9
ER -