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New antithrombotic agents: are they needed and what can they offer to patients with a non-ST-elevation acute coronary syndrome?Van de Werf FEur Heart J 2009[Jul]; 30 (14): 1695-702Antithrombotic therapy is a cornerstone of treatment for non-ST-segment elevation acute coronary syndromes, as demonstrated in numerous clinical trials. Long-term oral antiplatelet therapy targeting specific platelet activation pathways has demonstrated significant long-term benefits, whereas antithrombin use is limited to the acute setting. Despite proven efficacy of long-term dual oral antiplatelet therapy with aspirin and clopidogrel, residual morbidity and mortality is considerable. This may be partly due to incomplete inhibition of platelet activation with current agents and/or lack of long-term anticoagulant therapy. Improvements in patient outcomes could be achieved by developing agents that inhibit other platelet activation pathways or by adding new anticoagulants such as oral anti-IIa or anti-Xa agents for a prolonged period of time after the acute event. This review describes the rationale behind and the current status of the trials with new antithrombotic agents.|Acute Coronary Syndrome/*drug therapy/mortality[MESH]|Anticoagulants/*therapeutic use[MESH]|Fibrinolytic Agents/*therapeutic use[MESH]|Humans[MESH]|Platelet Activation/*drug effects[MESH]|Practice Guidelines as Topic[MESH] |
