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Semin Thromb Hemost 2004; 30(6): 627-632
DOI: 10.1055/s-2004-861504
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Current Role of Antithrombotic Agents in the Treatment of Acute Coronary Syndromes

Debabrata Mukherjee1 , 2 , Eric R. Bates2
  • 1Tyler Gill Professor of Interventional Cardiology, Division of Vascular Medicine, Gill Heart Institute, University of Kentucky, Lexing ton, Kentucky
  • 2Division of Cardiovascular Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Publication History

Publication Date:
04 January 2005 (online)

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ABSTRACT

Acute coronary syndromes (ACS) refer to a spectrum of myocardial ischemic disorders characterized by atherothrombotic plaque disruption. The management of ACS presents a challenge to the cardiologist because treatment strategies continue to evolve. Thrombin plays a pivotal role in thrombus formation, converting fibrinogen to fibrin, activating platelets, and recruiting additional platelets into the platelet-rich thrombus. In addition to unfractionated heparin (UFH), newer antithrombotic agents are now available and have significantly changed contemporary clinical practice. Low-molecular-weight heparins (LMWHs) has been shown to be superior to UFH in several trials. Direct thrombin inhibitors (DTIs) have been shown to be effective in patients undergoing elective coronary interventions and are being evaluated in patients with ACS. We review two classes of antithrombotic drugs, the LMWHs and the DTIs and discuss their current roles in the management of patients with ACS.

KEYWORDS

Acute coronary syndromes - low-molecular-weight heparins - direct thrombin inhibitors - bivalirudin - enoxaparin

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Debabrata MukherjeeM.D. 

Division of Cardivascular Medicine, Gill Heart Institute

900 S. Lime Stone, 326 B Wellington Bldg

Lexing ton, KY 40536-0200

Email: Mukherjee@uky.edu

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