Early anticoagulation in the current management of NSTE-ACS: Evidence, guidelines, practice and perspectives

Mattia Galli, Italo Porto, Felicita Andreotti, Domenico D'Amario, Rocco Vergallo, Roberta Della Bona, Filippo Crea

Research output: Contribution to journalArticle

Abstract

Anticoagulant therapy during the acute phase of non-ST elevation acute coronary syndromes (NSTE-ACS) is strongly recommended by current international guidelines. Evidence supporting the use of anticoagulant therapy in the early phase of NSTE-ACS however, is based on dated trials mostly performed in the nineties and recent randomised clinical trials (RCTs), performed during the last 15 years, clearly evidence a dichotomy in the investigation of antiplatelet and anticoagulant strategies. Many innovations have since occurred in the diagnosis and management of NSTE-ACS. Since a RCT evaluating the efficacy of anticoagulant therapy versus placebo in a contemporary setting of NSTE-ACS management is lacking, we provide a systematic review of 1) the randomised data for ATT in the early phase of NSTE-ACS; 2) modern international guidelines, and 3) contemporary clinical practice data. The results are analysed and potential treatment and research strategies are proposed.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalInternational Journal of Cardiology
Volume275
DOIs
Publication statusPublished - Jan 15 2019

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Acute Coronary Syndrome
Practice Guidelines
Anticoagulants
Randomized Controlled Trials
Guidelines
Therapeutics
Placebos
Research

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Early anticoagulation in the current management of NSTE-ACS : Evidence, guidelines, practice and perspectives. / Galli, Mattia; Porto, Italo; Andreotti, Felicita; D'Amario, Domenico; Vergallo, Rocco; Della Bona, Roberta; Crea, Filippo.

In: International Journal of Cardiology, Vol. 275, 15.01.2019, p. 39-45.

Research output: Contribution to journalArticle

Galli, Mattia ; Porto, Italo ; Andreotti, Felicita ; D'Amario, Domenico ; Vergallo, Rocco ; Della Bona, Roberta ; Crea, Filippo. / Early anticoagulation in the current management of NSTE-ACS : Evidence, guidelines, practice and perspectives. In: International Journal of Cardiology. 2019 ; Vol. 275. pp. 39-45.
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AU - D'Amario, Domenico

AU - Vergallo, Rocco

AU - Della Bona, Roberta

AU - Crea, Filippo

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