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Trends in Off-Label Indications of Non-Vitamin K Antagonist Oral Anticoagulants in Acute Coronary Syndrome. | LitMetric

Trends in Off-Label Indications of Non-Vitamin K Antagonist Oral Anticoagulants in Acute Coronary Syndrome.

Rev Cardiovasc Med

Department of Cardiothoracic Surgery/Intensive Care Unit, Heart Hospital, Hamad Medical Corporation, 3050 Doha, Qatar.

Published: June 2023

AI Article Synopsis

  • Acute coronary syndrome (ACS) is a major global health issue and often leads to high rates of recurrent thrombotic complications, even with recommended antiplatelet therapies.
  • Increased thrombin levels during ACS may indicate the need for additional anticoagulation therapies to further reduce these complications.
  • Non-vitamin K antagonist oral anticoagulants (NOACs) offer benefits like preventing thrombus formation and managing left ventricular thrombus, but they also present a higher risk of bleeding and are increasingly used for non-approved (off-label) indications in ischemic coronary disease.

Article Abstract

Acute coronary syndrome (ACS) is a leading cause of mortality worldwide. Despite optimal antiplatelet therapy recommendation after ischemic events, recurrent thrombotic complications rate remains high. The recurrent events maybe in part due to increased thrombin levels during ACS which may underscore the need for an additional anticoagulation therapy. Given the advantages of non-vitamin K antagonist oral anticoagulants (NOACs) over warfarin, they have the potential to prevent thrombus formation, in the presence or absence of atrial fibrillation, but at the cost of increased risk of bleeding. NOACs have also shown a promising efficacy in managing left ventricular thrombus and a potential benefit in avoiding stent thrombosis after percutaneous coronary revascularization. Taken as a whole, NOACs are increasingly used for off-licence indications, and continue to evolve as essential therapy in preventing and treating thrombotic events. Herein, this review discusses NOACs off-label indications in the setting of ischemic coronary disease.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264133PMC
http://dx.doi.org/10.31083/j.rcm2406180DOI Listing

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