Selecting the optimal antithrombotic regimen for patients with acute coronary syndromes undergoing percutaneous coronary intervention

Abstract

Shailja V Parikh1, Ellen C Keeley21Departments of Internal Medicine, Divisions of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, 2University of Virginia, Charlottesville, Virginia, USAAbstract: The wide variety of anticoagulant and antiplatelet agents available for clinical use has made choosing the optimal antithrombotic regimen for patients with acute coronary syndromes undergoing percutaneous coronary intervention a complex task. While there is no single best regimen, from a risk-benefit ratio standpoint, particular regimens may be considered optimal for different patients. We review the mechanisms of action for the commonly prescribed antithrombotic medications, summarize pertinent data from randomized trials on their use in acute coronary syndromes, and provide an algorithm (incorporating data from these trials as well as risk assessment instruments) that will help guide the decision-making process.Keywords: anticoagulant, antiplatelet, percutaneous coronary intervention