Early anticoagulation in the current management of NSTE-ACS: Evidence, guidelines, practice and perspectives

Felicita Andreotti, Filippo Crea, Mattia Galli, Italo Porto, Rocco Vergallo, Roberta Della Bona

Research output: Contribution to journalArticle

6 Citations (Scopus)


Anticoagulant therapy during the acute phase of non-ST elevation acute coronary syndromes (NSTE-ACS) is strongly recommended by current international guidelines. Evidence supporting the use of anticoagulant therapy in the early phase of NSTE-ACS however, is based on dated trials mostly performed in the nineties and recent randomised clinical trials (RCTs), performed during the last 15 years, clearly evidence a dichotomy in the investigation of antiplatelet and anticoagulant strategies. Many innovations have since occurred in the diagnosis and management of NSTE-ACS. Since a RCT evaluating the efficacy of anticoagulant therapy versus placebo in a contemporary setting of NSTE-ACS management is lacking, we provide a systematic review of 1) the randomised data for ATT in the early phase of NSTE-ACS; 2) modern international guidelines, and 3) contemporary clinical practice data. The results are analysed and potential treatment and research strategies are proposed. (c) 2018 Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)39-45
Number of pages7
Publication statusPublished - 2019


  • Acute Coronary Syndrome
  • Anticoagulants
  • Disease Management
  • Early phase
  • Electrocardiography
  • Humans
  • Modern management
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Thrombolytic Therapy
  • Time Factors


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