Review of Newer Anticoagulants and Anti-platelet Agents in Acute Coronary Syndrome and Cardiovascular Diseases
In the last few years three new oral anticoagulants-Dabigatran, Rivaroxaban and Apixaban and two new
antiplatelet agents Prasugrel and Ticagrelor have been approved for use. Dabigatran, Rivaroxaban and Apixaban have been
approved for the prevention of stroke and systemic embolism in non valvular Atrial Fibrillation in the United States.
Rivaroxaban is also approved for the prevention and treatment of venous thromboembolism, including pulmonary embolism.
These drugs have been shown to be non-inferior to Warfarin. These drugs do not need monitoring and have lesser drug
interactions compared to Warfarin. The newer antiplatelet agents Prasugrel and Ticagrelor are more potent than Clopidogrel
and are more effective in patients with CYP2 C19 enzyme deficiency. Both of these drugs are approved in acute coronary
syndrome and Prasugrel is approved only in acute coronary syndrome with percutaneous coronary intervention.
Keywords: Apixaban, cardiovascular diseases, Dabigatran, newer antiplatelet agents, newer oral anticoagulants, Prasugrel,
Rivaroxaban, thromboembolism, Ticagrelor.
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