Oral anticoagulants combined with aspirin in the prolonged treatment after acute coronary syndrome
Di Pasquale, G.; Biancoli, S.; Cerè, E.; Parlangeli, R.
Italian Heart Journal. Suppl Official Journal of the Italian Federation of Cardiology 3(5): 495-501
2002
ISSN/ISBN: 1129-4728 PMID: 12064188 Document Number: 549469
The incidence of death or myocardial infarction after acute coronary syndrome (ACS) is still high despite the widespread use of aspirin. Oral anticoagulant therapy (OAT) reducing thrombin activity has the potential to be beneficial when administered alone or in combination with aspirin after ACS. Low-intensity OAT in combination with aspirin is not superior to aspirin alone. Moderate-intensity OAT in combination with aspirin is superior to aspirin alone in reducing death, myocardial infarction or stroke after ACS. However, this regimen has higher rates of both minor and major hemorrhages. The bleeding risk combined with the difficulties of OAT management contributes to suboptimal compliance and has the potential to mitigate the superior efficacy of combined regimens.