Abstract
In patients with acute coronary syndrome (ACS), the combination of dual antiplatelet therapy (DAT) and parenteral anticoagulants (unfractionated or low molecular weight heparin or fondaparinux) in the acute (inpatient) phase of the disease correlates with the most significant reduction in cardiovascular complications (CVC). Numerous attempts have been made to prolong the anticoagulant potential with enteral medications during long-term prevention of CVC in the outpatient setting in patients with recurrent ACS, both with vitamin K antagonists and new oral anticoagulants. J. Oldgren et al., based on the results of a metaanalysis of seven such studies, concluded that addition of an enteral anticoagulant “on top” of acetylsalicylic acid or DAT after an ACS episode is accompanied by a significant reduction in the risk of major CVC, while the hemorrhage frequency increases almost two-fold. [1]
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