Acute coronary syndrome in patients treated by vitamin K antagonists or non-vitamin K antagonist oral anticoagulants: Proposed management algorithm for the first 48hours.

Fiche publication

Date publication

avril 2024

Journal

Archives of cardiovascular diseases

Auteurs

Membres identifiés du Cancéropôle Est :
Pr COTTIN Yves

Tous les auteurs :
Salaun A, de Maistre E, Daller M, Sombrun C, Chagué F, Bichat F, Rochette L, Danchin N, Fauchier L, Zeller M, Cottin Y

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/38644068

Résumé

Around 10% of patients with acute coronary syndrome are treated by vitamin K antagonists or non-vitamin K antagonist oral anticoagulants for various indications. The initial management of these patients is highly complex, and new guidelines specify that, only during percutaneous coronary intervention, a bolus of unfractionated heparin is recommended in one of the following circumstances: (1) if the patient is receiving a non-vitamin K antagonist oral anticoagulant; or (2) if the international normalized ratio is<2.5 in a patient being treated with a vitamin K antagonist. In this review, we report on five key messages essential for the management of these patients. There are no randomized studies to date, and we propose two diagnostic and/or therapeutic decision algorithms. However, randomized studies are needed to validate these strategies.