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- Juan P Costabel, Ernesto Duronto, Javier Guetta, José Ceresetto, Fernando Guardiani, Juan P Fescina, Gastón Procopio, Marcelo Casey, Claudio Higa, Ricardo Villareal, José Bonorino, and Pablo Lamelas.
- Servicio de Cardiología, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. E-mail: jpcostabel@icba.com.ar.
- Medicina (B Aires). 2023 Jan 1; 83 (6): 948965948-965.
AbstractAnticoagulant treatment, together with antiplatelet therapy, plays an important role in the treatment of acute coronary syndromes. Its use is associated with a reduction in new ischemic events, stent thrombosis, and lower mortality. However, in clinical practice there is great heterogeneity in its use, leading to suboptimal results in treatment. This paper conducts a narrative review on the use of parenteral anticoagulants in patients with acute coronary syndromes, depending on the clinical scenario, as well as the revascularization strategy used and the bleeding risk. The different anticoagulant schemes available in acute coronary syndromes with and without segment ST elevation are addressed, based on the updated evidence. Finally, evidence-based strategies for risk stratification for bleeding and therapeutic management are developed.
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