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Medicina (Buenos Aires)

versión impresa ISSN 0025-7680versión On-line ISSN 1669-9106


COSTABEL, Juan P. et al. Use of parenteral anticoagulants in patients with coro nary syndromes. Medicina (B. Aires) [online]. 2023, vol.83, n.6, pp.948-965. ISSN 0025-7680.

Anticoagulant treatment, together with antiplatelet therapy, plays an important role in the treatment of acute coronary syndromes. Its use is associated with a reduction in new ischemic events, stent thrombosis, and lower mortality.

However, in clinical practice there is great heterogene ity in its use, leading to suboptimal results in treatment.

This paper conducts a narrative review on the use of parenteral anticoagulants in patients with acute coronary syndromes, depending on the clinical scenario, as well as the revascularization strategy used and the bleeding risk.

The different anticoagulant schemes available in acute coronary syndromes with and without segment ST elevation are addressed, based on the updated evidence.

Finally, evidence-based strategies for risk stratifi cation for bleeding and therapeutic management are developed.

Palabras clave : Anticoagulation; acute coronary syn drome; Bleeding; Heparin; Bivalirudin; Fondaparinux.

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