Journal Article

Apixaban with Antiplatelet Therapy after Acute Coronary Syndrome

Geraldes, Margarida, Lawrence, Jack, Kilaru, Rakhi, De Caterina, Raffaele, Husted, Steen E, Lopez-Sendon, Jose, Alexander, John H, Ruda, Mikhail, Darius, Harald, Atar, Dan, James, Stefan, He, Yaohua, Harrington, Robert A, Wallentin, Lars, Cools, Frank, Keltai, Matyas, Leiva-Pons, Jose Luis, Pais, Prem, Parkhomenko, Alexander, Diaz, Rafael, Liaw, Danny, Mohan, Puneet, Bhatt, Deepak L, White, Harvey, Vinereanu, Dragos, Goodman, Shaun, Jansky, Petr, Lopes, Renato D, Huber, Kurt, Flather, Marcus, Cornel, Jan H, Ogawa, Hisao, Ruzyllo, Witold, Verheugt, Freek W

2011

Overview

In a randomized trial, patients with an acute coronary syndrome were assigned to receive apixaban or placebo in addition to standard therapy. The apixaban group had a higher rate of TIMI major bleeding and no significant reduction in recurrent ischemic events. Patients with acute coronary syndromes frequently have recurrent ischemic events despite the use of currently recommended antiplatelet therapy, revascularization procedures as appropriate, and other evidence-based secondary preventive measures. 1 – 3 Oral anticoagulation therapy with vitamin K antagonists reduces the incidence of recurrent ischemic events after myocardial infarction but also increases the risk of bleeding when it is added to aspirin or aspirin and clopidogrel. 4 – 9 Apixaban, an orally active, selective, direct factor Xa inhibitor, has been shown to reduce the incidence of venous thromboembolism in patients undergoing orthopedic surgery and to prevent thromboembolic events in patients with atrial fibrillation who are . . .

• Publisher: Massachusetts Medical Society
• Subject: Acute Coronary Syndrome - drug therapy / Acute Coronary Syndrome - mortality / Acute coronary syndromes / Aged / Angina pectoris / Angina, Unstable - epidemiology / Angina, Unstable - prevention & control / Anticoagulants / Antiplatelet therapy / Aspirin / Aspirin - adverse effects / Aspirin - therapeutic use / Biological and medical sciences / Bleeding / Bone surgery / Cardiology. Vascular system / Cerebral infarction / Clinical trials / Coronary heart disease / Disease prevention / Double-Blind Method / Double-blind studies / Drug Therapy, Combination / Factor Xa Inhibitors / Female / General aspects / Health risk assessment / Heart / Heart attacks / Hemorrhage - chemically induced / Humans / Ischemia / Kaplan-Meier Estimate / Male / Medical sciences / Middle Aged / Myocardial infarction / Myocardial Infarction - epidemiology / Myocardial Infarction - prevention & control / Myocarditis. Cardiomyopathies / Platelet Aggregation Inhibitors - adverse effects / Platelet Aggregation Inhibitors - therapeutic use / Proportional Hazards Models / Pyrazoles - adverse effects / Pyrazoles - therapeutic use / Pyridones - adverse effects / Pyridones - therapeutic use / Risk factors / Risk groups / Statistical analysis / Stroke / Stroke - epidemiology / Stroke - prevention & control / Thrombolysis / Thrombosis / Treatment Outcome