Acute coronary syndrome in patients treated by vitamin K antagonists or non-vitamin K antagonist oral anticoagulants: Proposed management algorithm for the first 48 hours - 01/06/24
Graphical abstract |
Highlights |
• | About 10% of patients with ACS are treated by VKAs or NOACs. | ||||
• | The initial management of these patients is highly complex. | ||||
• | New guidelines specify that, only during PCI, a bolus of UFH is recommended if:
| ||||
• | No randomized study has been performed in this specific population. | ||||
• | Proposed algorithms are therefore a synthesis of diagnostic/therapeutic approaches. |
Abstract |
Around 10% of patients with acute coronary syndrome are treated by vitamin K antagonists or non-vitamin K antagonist oral anticoagulants for various indications. The initial management of these patients is highly complex, and new guidelines specify that, only during percutaneous coronary intervention, a bolus of unfractionated heparin is recommended in one of the following circumstances: (1) if the patient is receiving a non-vitamin K antagonist oral anticoagulant; or (2) if the international normalized ratio is<2.5 in a patient being treated with a vitamin K antagonist. In this review, we report on five key messages essential for the management of these patients. There are no randomized studies to date, and we propose two diagnostic and/or therapeutic decision algorithms. However, randomized studies are needed to validate these strategies.
Le texte complet de cet article est disponible en PDF.Keywords : Acute coronary syndrome, Vitamin K antagonist, Non-vitamin K antagonist oral anticoagulant, Atrial fibrillation, Bleeding
Plan
| ☆ | Tweet: About 10% of patients with acute coronary syndrome receive anticoagulants. Initial management is highly complex, and new guidelines recommend unfractionated heparin only under specific circumstances. In this review, we report on five key messages for managing these patients. |
Vol 117 - N° 5
P. 351-357 - mai 2024 Retour au numéro
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