Management of acute coronary syndrome: Achievements and goals still to pursue. Novel developments in diagnosis and treatment

Journal of Internal Medicine

Volumn 271, Issue 6, 2012, Pages 521-536

  Boden, H ^a   van der Hoeven, B L ^a   Karalis, I ^a   Schalij, M J ^a   Jukema, J W ^a  

^a LEIDEN UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

Acute coronary syndrome; Therapeutics

Indexed keywords

ABCIXIMAB; ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; APIXABAN; CLOPIDOGREL; DABIGATRAN; DAREXABAN; ENOXAPARIN; EPTIFIBATIDE; FONDAPARINUX; HEPARIN; HIRULOG; LOW MOLECULAR WEIGHT HEPARIN; PLACEBO; PRASUGREL; RIVAROXABAN; THIENOPYRIDINE DERIVATIVE; THROMBIN INHIBITOR; TICAGRELOR; TIROFIBAN; VORAPAXAR;

ACUTE CORONARY SYNDROME; ANTICOAGULANT THERAPY; BLEEDING; BRAIN HEMORRHAGE; CORONARY REPERFUSION; DRUG HALF LIFE; DRUG MEGADOSE; EARLY DIAGNOSIS; FIBRINOLYSIS; FIBRINOLYTIC THERAPY; HEPARIN INDUCED THROMBOCYTOPENIA; HIGH RISK PATIENT; HUMAN; ISCHEMIA; LOW DRUG DOSE; MORBIDITY; MORTALITY; NON ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; PERCUTANEOUS CORONARY INTERVENTION; PRIORITY JOURNAL; REVIEW; ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; TWO DIMENSIONAL ECHOCARDIOGRAPHY;

ACUTE CORONARY SYNDROME; ANGIOPLASTY, BALLOON, CORONARY; CLINICAL TRIALS AS TOPIC; EARLY DIAGNOSIS; FIBRINOLYTIC AGENTS; HEMORRHAGE; HUMANS; MYOCARDIAL REPERFUSION; RISK ASSESSMENT; TIME FACTORS; TREATMENT OUTCOME;

EID: 84861228053     PISSN: 09546820     EISSN: 13652796     Source Type: Journal    
DOI: 10.1111/j.1365-2796.2012.02533.x     Document Type: Review

References (98)

1. Fox KA, Steg PG, Eagle KA et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006. JAMA 2007; 297: 1892-900.
2. World Health Organization. Mortality and burden of disease. 2012.
3. Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature 2011; 473: 317-25.
4. Yla-Herttuala S, Bentzon JF, Daemen M et al. Stabilisation of atherosclerotic plaques. Position paper of the European Society of Cardiology (ESC) Working Group on atherosclerosis and vascular biology. Thromb Haemost 2011; 106: 1-19.
5. Anderson JL, Adams CD, Antman EM et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol 2007; 50: e1-157.
6. Thygesen K, Alpert JS, White HD et al. Universal definition of myocardial infarction. Circulation 2007; 116: 2634-53.
7. Kushner FG, Hand M, Smith SC Jr et al. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2009; 54: 2205-41.
8. Wright RS, Anderson JL, Adams CD et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 123: 2022-60.
9. Van de Werf F, Bax J, Betriu A et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J 2008; 29: 2909-45.
10. Hamm CW, Bassand JP, Agewall S et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2011; 32: 2999-3054.
11. Terkelsen CJ, Sorensen JT, Maeng M et al. System delay and mortality among patients with STEMI treated with primary percutaneous coronary intervention. JAMA 2010; 304: 763-71.
12. Lambert L, Brown K, Segal E, Brophy J, Rodes-Cabau J, Bogaty P. Association between timeliness of reperfusion therapy and clinical outcomes in ST-elevation myocardial infarction. JAMA 2010; 303: 2148-55.
13. Kalla K, Christ G, Karnik R et al. Implementation of guidelines improves the standard of care: the Viennese registry on reperfusion strategies in ST-elevation myocardial infarction (Vienna STEMI registry). Circulation 2006; 113: 2398-405.
14. Liem SS, van der Hoeven BL, Oemrawsingh PV et al. MISSION!: optimization of acute and chronic care for patients with acute myocardial infarction. Am Heart J 2007; 153: 14.e1-11.
15. Mehta RH, Montoye CK, Gallogly M et al. Improving quality of care for acute myocardial infarction: the Guidelines Applied in Practice (GAP) Initiative. JAMA 2002; 287: 1269-76.
16. Naegeli B, Radovanovic D, Rickli H et al. Impact of a nationwide public campaign on delays and outcome in Swiss patients with acute coronary syndrome. Eur J Cardiovasc Prev Rehabil 2011; 18: 297-304.
17. Goldberg RJ, Spencer FA, Fox KA et al. Prehospital delay in patients with acute coronary syndromes (from the Global Registry of Acute Coronary Events [GRACE]). Am J Cardiol 2009; 103: 598-603.
18. Pedersen SH, Galatius S, Hansen PR et al. Field triage reduces treatment delay and improves long-term clinical outcome in patients with acute ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol 2009; 54: 2296-302.
19. Brieger D, Eagle KA, Goodman SG et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the Global Registry of Acute Coronary Events. Chest 2004; 126: 461-9.
20. Antman EM, Tanasijevic MJ, Thompson B et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996; 335: 1342-9.
21. Katus HA, Remppis A, Neumann FJ et al. Diagnostic efficiency of troponin T measurements in acute myocardial infarction. Circulation 1991; 83: 902-12.
22. Gerhardt W, Ljungdahl L, Herbert AK. Troponin-T and CK MB (mass) in early diagnosis of ischemic myocardial injury. The Helsingborg Study, 1992. Clin Biochem 1993; 26: 231-40.
23. Pervaiz S, Anderson FP, Lohmann TP et al. Comparative analysis of cardiac troponin I and creatine kinase-MB as markers of acute myocardial infarction. Clin Cardiol 1997; 20: 269-71.
24. Keller T, Zeller T, Peetz D et al. Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N Engl J Med 2009; 361: 868-77.
25. Autore C, Agati L, Piccininno M, Lino S, Musaro S. Role of echocardiography in acute chest pain syndrome. Am J Cardiol 2000; 86: 41G-2G.
26. Sorensen JT, Terkelsen CJ, Steengaard C et al. Prehospital troponin T testing in the diagnosis and triage of patients with suspected acute myocardial infarction. Am J Cardiol 2011; 107: 1436-40.
27. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003; 361: 13-20.
28. Antman EM. Time is muscle: translation into practice. J Am Coll Cardiol 2008; 52: 1216-21.
29. Boersma E. Does time matter? A pooled analysis of randomized clinical trials comparing primary percutaneous coronary intervention and in-hospital fibrinolysis in acute myocardial infarction patients. Eur Heart J 2006; 27: 779-88.
30. Tarantini G, Van de Werf F, Bilato C, Gersh B. Primary percutaneous coronary intervention for acute myocardial infarction: is it worth the wait? The risk-time relationship and the need to quantify the impact of delay. Am Heart J 2011; 161: 247-53.
31. Hochman JS, Sleeper LA, Webb JG et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med 1999; 341: 625-34.
32. Wang TY, Nallamothu BK, Krumholz HM et al. Association of door-in to door-out time with reperfusion delays and outcomes among patients transferred for primary percutaneous coronary intervention. JAMA 2011; 305: 2540-7.
33. Ellis SG, Tendera M, de Belder MA et al. Facilitated PCI in patients with ST-elevation myocardial infarction. N Engl J Med 2008; 358: 2205-17.
34. Keeley EC, Boura JA, Grines CL. Comparison of primary and facilitated percutaneous coronary interventions for ST-elevation myocardial infarction: quantitative review of randomised trials. Lancet 2006; 367: 579-88.
35. Di MC, Dudek D, Piscione F et al. Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial. Lancet 2008; 371: 559-68.
36. Cantor WJ, Fitchett D, Borgundvaag B et al. Routine early angioplasty after fibrinolysis for acute myocardial infarction. N Engl J Med 2009; 360: 2705-18.
37. Rathore SS, Curtis JP, Chen J et al. Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study. BMJ 2009; 338: b1807.
38. Wijeysundera HC, Vijayaraghavan R, Nallamothu BK et al. Rescue angioplasty or repeat fibrinolysis after failed fibrinolytic therapy for ST-segment myocardial infarction: a meta-analysis of randomized trials. J Am Coll Cardiol 2007; 49: 422-30.
39. Fox KA, Clayton TC, Damman P et al. Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data. J Am Coll Cardiol 2010; 55: 2435-45.
40. Mehta SR, Granger CB, Boden WE et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med 2009; 360: 2165-75.
41. Katritsis DG, Siontis GC, Kastrati A et al. Optimal timing of coronary angiography and potential intervention in non-ST-elevation acute coronary syndromes. Eur Heart J 2011; 32: 32-40.
42. Montalescot G, Cayla G, Collet JP et al. Immediate vs delayed intervention for acute coronary syndromes: a randomized clinical trial. JAMA 2009; 302: 947-54.
43. Antman EM, Cohen M, Bernink PJ et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA 2000; 284: 835-42.
44. Granger CB, Goldberg RJ, Dabbous O et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med 2003; 163: 2345-53.
45. Boersma E, Pieper KS, Steyerberg EW et al. Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation. Results from an international trial of 9461 patients. The PURSUIT Investigators. Circulation 2000; 101: 2557-67.
46. Morrow DA, Antman EM, Parsons L et al. Application of the TIMI risk score for ST-elevation MI in the National Registry of Myocardial Infarction 3. JAMA 2001; 286: 1356-9.
47. Roffi M, Chew DP, Mukherjee D et al. Platelet glycoprotein IIb/IIIa inhibition in acute coronary syndromes. Gradient of benefit related to the revascularization strategy. Eur Heart J 2002; 23: 1441-8.
48. De LG, Suryapranata H, Stone GW et al. Abciximab as adjunctive therapy to reperfusion in acute ST-segment elevation myocardial infarction: a meta-analysis of randomized trials. JAMA 2005; 293: 1759-65.
49. Montalescot G, Antoniucci D, Kastrati A et al. Abciximab in primary coronary stenting of ST-elevation myocardial infarction: a European meta-analysis on individual patients' data with long-term follow-up. Eur Heart J 2007; 28: 443-9.
50. Simoons ML. Effect of glycoprotein IIb/IIIa receptor blocker abciximab on outcome in patients with acute coronary syndromes without early coronary revascularisation: the GUSTO IV-ACS randomised trial. Lancet 2001; 357: 1915-24.
51. De LG, Navarese EP, Cassetti E, Verdoia M, Suryapranata H. Meta-analysis of randomized trials of glycoprotein IIb/IIIa inhibitors in high-risk acute coronary syndromes patients undergoing invasive strategy. Am J Cardiol 2011; 107: 198-203.
52. Hassan AK, Liem SS, van der Kley F et al. In-ambulance abciximab administration in STEMI patients prior to primary PCI is associated with smaller infarct size, improved LV function and lower incidence of heart failure: results from the Leiden MISSION! acute myocardial infarction treatment optimization program. Catheter Cardiovasc Interv 2009; 74: 335-43.
53. Rakowski T, Siudak Z, Dziewierz A et al. Early abciximab administration before transfer for primary percutaneous coronary interventions for ST-elevation myocardial infarction reduces 1-year mortality in patients with high-risk profile. Results from EUROTRANSFER registry. Am Heart J 2009; 158: 569-75.
54. De LG, Bellandi F, Huber K et al. Early glycoprotein IIb-IIIa inhibitors in primary angioplasty- abciximab long-term results (EGYPT-ALT) cooperation. An individual patients' data meta-analysis. J Thromb Haemost 2011; 9: 2361-70.
55. Huber K, Holmes DR Jr, van't Hof AW et al. Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial. Eur Heart J 2010; 31: 1708-16.
56. [No authors listed]. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17, 187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet 1988; 2: 349-60.
57. Mehta SR, Yusuf S, Peters RJ et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358: 527-33.
58. Chen ZM, Jiang LX, Chen YP et al. Addition of clopidogrel to aspirin in 45, 852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005; 366: 1607-21.
59. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345: 494-502.
60. Koul S, Smith JG, Schersten F, James S, Lagerqvist B, Erlinge D. Effect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Eur Heart J 2011; 32: 2989-97.
61. Dorler J, Edlinger M, Alber HF et al. Clopidogrel pre-treatment is associated with reduced in-hospital mortality in primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Eur Heart J 2011; 32: 2954-61.
62. Steinhubl SR, Berger PB, Mann JT III et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002; 288: 2411-20.
63. Snoep JD, Hovens MM, Eikenboom JC, van der Bom JG, Jukema JW, Huisman MV. Clopidogrel nonresponsiveness in patients undergoing percutaneous coronary intervention with stenting: a systematic review and meta-analysis. Am Heart J 2007; 154: 221-31.
64. Price MJ, Berger PB, Teirstein PS et al. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA 2011; 305: 1097-105.
65. Mega JL, Simon T, Collet JP et al. Reduced-function CYP2C19 genotype and risk of adverse clinical outcomes among patients treated with clopidogrel predominantly for PCI: a meta-analysis. JAMA 2010; 304: 1821-30.
66. Mehta SR, Bassand JP, Chrolavicius S et al. Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. N Engl J Med 2010; 363: 930-42.
67. Wallentin L, Varenhorst C, James S et al. Prasugrel achieves greater and faster P2Y12receptor-mediated platelet inhibition than clopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease. Eur Heart J 2008; 29: 21-30.
68. Michelson AD, Frelinger AL III, Braunwald E et al. Pharmacodynamic assessment of platelet inhibition by prasugrel vs. clopidogrel in the TRITON-TIMI 38 trial. Eur Heart J 2009; 30: 1753-63.
69. Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001-15.
70. Montalescot G, Wiviott SD, Braunwald E et al. Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial. Lancet 2009; 373: 723-31.
71. Montalescot G, Sideris G, Cohen R et al. Prasugrel compared with high-dose clopidogrel in acute coronary syndrome. The randomised, double-blind ACAPULCO study. Thromb Haemost 2010; 103: 213-23.
72. Wiviott SD, Braunwald E, Angiolillo DJ et al. Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-Thrombolysis in Myocardial Infarction 38. Circulation 2008; 118: 1626-36.
73. Wiviott SD, Braunwald E, McCabe CH et al. Intensive oral antiplatelet therapy for reduction of ischaemic events including stent thrombosis in patients with acute coronary syndromes treated with percutaneous coronary intervention and stenting in the TRITON-TIMI 38 trial: a subanalysis of a randomised trial. Lancet 2008; 371: 1353-63.
74. Wallentin L, James S, Storey RF et al. Effect of CYP2C19 and ABCB1 single nucleotide polymorphisms on outcomes of treatment with ticagrelor versus clopidogrel for acute coronary syndromes: a genetic substudy of the PLATO trial. Lancet 2010; 376: 1320-8.
75. Cannon CP, Husted S, Harrington RA et al. Safety, tolerability, and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, compared with clopidogrel, in patients with non-ST-segment elevation acute coronary syndrome: primary results of the DISPERSE-2 trial. J Am Coll Cardiol 2007; 50: 1844-51.
76. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009; 361: 1045-57.
77. Steg PG, James S, Harrington RA et al. Ticagrelor versus clopidogrel in patients with ST-elevation acute coronary syndromes intended for reperfusion with primary percutaneous coronary intervention: a Platelet Inhibition and Patient Outcomes (PLATO) trial subgroup analysis. Circulation 2010; 122: 2131-41.
78. Cannon CP, Harrington RA, James S et al. Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study. Lancet 2010; 375: 283-93.
79. Storey RF, Angiolillo DJ, Patil SB et al. Inhibitory effects of ticagrelor compared with clopidogrel on platelet function in patients with acute coronary syndromes: the PLATO (PLATelet inhibition and patient Outcomes) PLATELET substudy. J Am Coll Cardiol 2010; 56: 1456-62.
80. Biondi-Zoccai G, Lotrionte M, Agostoni P et al. Adjusted indirect comparison meta-analysis of prasugrel versus ticagrelor for patients with acute coronary syndromes. Int J Cardiol 2011; 150: 325-31.
81. Tricoci P, Huang Z, Held C et al. Thrombin-receptor antagonist vorapaxar in acute coronary syndromes. N Engl J Med 2012; 366: 20-33.
82. Morrow DA, Scirica BM, Fox KA et al. Evaluation of a novel antiplatelet agent for secondary prevention in patients with a history of atherosclerotic disease: design and rationale for the Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2 degrees P)-TIMI 50 trial. Am Heart J 2009; 158: 335-41.
83. Telford AM, Wilson C. Trial of heparin versus atenolol in prevention of myocardial infarction in intermediate coronary syndrome. Lancet 1981; 1: 1225-8.
84. Montalescot G, Zeymer U, Silvain J et al. Intravenous enoxaparin or unfractionated heparin in primary percutaneous coronary intervention for ST-elevation myocardial infarction: the international randomised open-label ATOLL trial. Lancet 2011;378:693-703.
85. Mehran R, Lansky AJ, Witzenbichler B et al. Bivalirudin in patients undergoing primary angioplasty for acute myocardial infarction (HORIZONS-AMI): 1-year results of a randomised controlled trial. Lancet 2009;374:1149-59.
86. Kastrati A, Neumann FJ, Schulz S et al. Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction. N Engl J Med 2011; 365: 1980-9.
87. Oldgren J, Budaj A, Granger CB et al. Dabigatran vs. placebo in patients with acute coronary syndromes on dual antiplatelet therapy: a randomized, double-blind, phase II trial. Eur Heart J 2011; 32: 2781-9.
88. Yusuf S, Mehta SR, Chrolavicius S et al. Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: the OASIS-6 randomized trial. JAMA 2006; 295: 1519-30.
89. Yusuf S, Mehta SR, Chrolavicius S et al. Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med 2006; 354: 1464-76.
90. Mehta SR, Granger CB, Eikelboom JW et al. Efficacy and safety of fondaparinux versus enoxaparin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: results from the OASIS-5 trial. J Am Coll Cardiol 2007;50:1742-51.
91. Steg PG, Jolly SS, Mehta SR et al. Low-dose vs standard-dose unfractionated heparin for percutaneous coronary intervention in acute coronary syndromes treated with fondaparinux: the FUTURA/OASIS-8 randomized trial. JAMA 2010; 304: 1339-49.
92. Mega JL, Braunwald E, Wiviott SD et al. Rivaroxaban in patients with a recent acute coronary syndrome. N Engl J Med 2012; 366: 9-19.
93. Alexander JH, Lopes RD, James S et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med 2011; 365: 699-708.
94. Steg PG, Mehta SR, Jukema JW et al. RUBY-1: a randomized, double-blind, placebo-controlled trial of the safety and tolerability of the novel oral factor Xa inhibitor darexaban (YM150) following acute coronary syndrome. Eur Heart J 2011; 32: 2541-54.
95. Mehran R, Pocock S, Nikolsky E et al. Impact of bleeding on mortality after percutaneous coronary intervention results from a patient-level pooled analysis of the REPLACE-2 (randomized evaluation of PCI linking angiomax to reduced clinical events), ACUITY (acute catheterization and urgent intervention triage strategy), and HORIZONS-AMI (harmonizing outcomes with revascularization and stents in acute myocardial infarction) trials. JACC Cardiovasc Interv 2011; 4: 654-64.
96. Moscucci M, Fox KA, Cannon CP et al. Predictors of major bleeding in acute coronary syndromes: the Global Registry of Acute Coronary Events (GRACE). Eur Heart J 2003; 24: 1815-23.
97. Subherwal S, Bach RG, Chen AY et al. Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation 2009; 119: 1873-82.
98. Steg PG, Huber K, Andreotti F et al. Bleeding in acute coronary syndromes and percutaneous coronary interventions: position paper by the Working Group on Thrombosis of the European Society of Cardiology. Eur Heart J 2011; 32: 1854-64.