Recent Advances in Optimal Adjunctive Antithrombotic Therapy in STEMI Patients Undergoing Primary Angioplasty: an Overview.

Recent Advances in Optimal Adjunctive Antithrombotic Therapy in STEMI Patients Undergoing Primary Angioplasty: an Overview. Curr Vasc Pharmacol. 2014 Dec 28; Authors: De Luca G, Suryapranata H Abstract There has been a considerable effort to improve adjunctive antithrombotic therapies to reperfusion strategies in the treatment of ST-segment elevation Myocardial Infarction (STEMI). Therefore, the aim of this article is to provide a critical and updated overview of recent advances on adjunctive antithrombotic therapies in patients undergoing primary angioplasty for STEMI. Due to very low costs, early Unfractionated Heparin (UFH) plus additional periprocedural administration should still be regarded as the gold standard in antithrombotic therapy, whereas subsequent subcutaneous administration of Low Molecular Weight Heparins (LMWHs) or fondaparinux should be considered, especially in patients at higher risk of thromboembolic complications. Periprocedural bivalirudin should be considered instead of a strategy of combined UFH and Glycoprotein (Gp) IIb/IIIa inhibitors, especially among patients at higher risk of bleeding complications. New oral ADP antagonists should be administrated as early as possible soon after diagnosis, whereas the use of clopidogrel should be limited to the cases when the new ADP antagonists are not available or contraindicated. However, rivaroxaban has obtained indication for Acute Coronary Syndromes (ACS), and the...
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research