الفهرس 
Acute coronary syndromeOnly 14 pages are availabe for public view
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Abstract
Although significant advances in the treatment of acute coronary syndromes (ACS) have been made in the last years, they still remain one of the major causes of admission and death in the intensive care units (ICU). Extensive data support the use of intravenous GPIs in the setting of moderate or high-risk NSTE-ACS, particularly if an early invasive strategy is planned. In the setting of low-risk ACS, GPIs may not be useful, and are potentially harmful, in troponin negative patients in whom a conservative management strategy is planned, or if the bleeding risk is elevated. The recent update to the ACC/AHA STEMI guidelines assigns a class I recommendation to clopidogrel or prasugrel for patients in whom PCI is planned. Ticagrelor is a novel oral ADP receptor blocker not yet approved for use; however, recently published results from the Study of Platelet Inhibition and Patient Outcomes (PLATO) are promising. Cangrelor, an intravenous, rapid-onset, reversible ADP receptor blocker, was studied in two recently reported randomized placebo-controlled trials. Although these two trials were stopped early, findings of reduced stent thrombosis and mortality were recorded. Based on HORIZON-AMI trial, the 2009 update to the ACC/AHA guidelines for STEMI assigns a class I indication to the use of bivalirudin in patients undergoing primary PCI. There was no benefit with fondaparinux in patients with STEMI undergoing primary PCI. In this group, there was a higher rate of catheter thrombosis. So efforts are required for developing novel antithrombotics with good safety and efficacy.