Direct oral anticoagulants plus antiplatelets effective in ACS

Direct oral anticoagulants plus antiplatelets effective in ACS
(HealthDay)—For patients with acute coronary syndrome (ACS), treatment with direct oral anticoagulants (DOACs) in addition to antiplatelet therapy (APT) appears efficacious for those with ST-segment elevation myocardial infarction (STEMI), according to a review published online Feb. 7 in JAMA Cardiology.

Mauro Chiarito, M.D., from Humanitas University in Milan, and colleagues examined the safety and efficacy of DOAC in addition to APT after ACS using data from six trials with 29,667 patients (14,580 patients with STEMI and 15,036 with non-ST-segment elevation ACS [NSTE-ACS]).

The researchers found that the risk of the primary efficacy end point (composite of cardiovascular death, , and stroke) was significantly lower for patients treated with DOAC versus APT alone (odds ratio, 0.85; 95 percent confidence interval, 0.77 to 0.93; P < 0.001). Patients with STEMI had pronounced benefit (odds ratio, 0.76; 95 percent confidence interval, 0.66 to 0.88; P < 0.001), while patients with NSTE-ACS had no significant treatment effect (odds ratio, 0.92; 95 percent interval, 0.78 to 1.09; P = 0.36; P for interaction = 0.09). Compared with APT alone, DOACs were correlated with significantly increased risk of major bleeding, with consistent results for with STEMI and NSTE-ACS.

"To our knowledge, these findings are the first evidence to support differential treatment effects of DOAC in addition to APT according to ACS baseline clinical presentation," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.


Explore further

Diabetes confers worse prognosis for patients with ACS

More information: Abstract/Full Text (subscription or payment may be required)

Copyright © 2018 HealthDay. All rights reserved.

Citation: Direct oral anticoagulants plus antiplatelets effective in ACS (2018, February 9) retrieved 22 February 2019 from https://medicalxpress.com/news/2018-02-oral-anticoagulants-antiplatelets-effective-acs.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
3 shares

Feedback to editors

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more