Why are Antiplatelets used in ACS?

Antiplatelet agents have been used for decades to improve outcomes in patients with ACS and may do so not only through their antithrombotic properties but also through their anti-inflammatory effects, although their relative contribution in this context remains a subject of debate.

How long should you give dual antiplatelet therapy in patients with ACS?

Duration of dual antiplatelet therapy in ACS The currently recommended duration of DAPT for patients with ACS, non-ST-segment elevation ACS (NSTE-ACS) as well as ST-segment elevation ACS (STE-ACS) is 12 months [9].

Why do we use fondaparinux in ACS?

Fondaparinux provides a prophylactic level of anticoagulation and thus this will also act as a thromboprophylactic agent in these patients. As Fondaparinux at this dose provides a prophylactic level of anticoagulation it is not suitable for indications where a therapeutic level of anticoagulation is required eg.

Why is aspirin given in ACS?

It is recommended that aspirin-naive patients having ACS chew a loading dose of at least 160 mg of aspirin to receive prompt antiplatelet effect. The benefits of aspirin emanate not only from its antiplatelet effects, but potentially also from its anti-inflammatory properties.

Why is clopidogrel given for MI?

Clopidogrel reduces the risk of death and cardiovascular complications in patients with symptomatic atherosclerotic disease, in the setting of percutaneous coronary intervention (PCI), and in patients with unstable angina or non-STEMI.

When is dual antiplatelet therapy indicated?

Dual antiplatelet therapy is recommended for an ABCD2 score of 4 or greater. Minor stroke can be identified by a National Institutes of Health (NIH) Stroke Scale score of 3 or less. The risk of recurrence after minor stroke is similar to that after a high-risk TIA.

When do you hold antiplatelet therapy?

If a patient’s bleeding risk significantly outweighs the risk of stent thrombosis, or if active hemorrhage makes a patient hemodynamically unstable, antiplatelet therapy must be stopped.

Who needs dual antiplatelet therapy?

When do you use enoxaparin vs fondaparinux?

First, in the short term, fondaparinux and enoxaparin have similar efficacy. Second, as compared with enoxaparin, fondaparinux substantially reduces bleeding. Third, the reduced bleeding that accompanies the use of fondaparinux is associated with lower long-term mortality and morbidity.

When do you use enoxaparin and fondaparinux?

Conclusion. In patients who were treated for ACS, fondaparinux might be a better choice when compared to enoxaparin in terms of short to midterm bleeding events. This result was mainly applicable to patients with NSTEMI.