Factor Xa inhibitors, a new class of oral anticoagulants, have been evaluated in the phase II ATLAS ACS-TIMI 46 and APPRAISE trials. Addition of these agents to standard therapy has tended to reduce the incidence of adverse cardiovascular events at the expense of a dose-dependent increase in the risk of bleeding complications.
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References
Wiviott, S. et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N. Engl. J. Med. 357, 2001–2015 (2007).
The Clopidogrel in Unstable Angina to Prevent Recurrent Ischemic Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N. Engl. J. Med. 345, 494–502 (2001).
Rothberg, M. B., Celestin, C., Fiore, L. D., Lawler, E. & Cook, J. R. Warfarin plus aspirin after myocardial infarction or the acute coronary syndrome: meta-analysis with estimates of risk and benefit. Ann. Intern. Med. 143, 241–250 (2005).
Mega, J. L. et al. Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase II trial. Lancet 374, 29–38 (2009).
APPRAISE Steering Committee and Investigators. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 119, 2877–2885 (2009).
Agnelli, G. et al. Treatment of proximal deep-vein thrombosis with the oral direct factor Xa inhibitor rivaroxaban (BAY 59–7939): The ODIXa-DVT (Oral Direct Factor Xa Inhibitor BAY 59–7939 in Patients With Acute Symptomatic Deep-Vein Thrombosis) study. Circulation 116, 180–187 (2007).
Turpie, A. G. et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial. Lancet 373, 1673–1680 (2009).
Botticelli investigators. Efficacy and safety of the oral direct factor Xa inhibitor apixaban for symptomatic deep vein thrombosis. The Botticelli DVT dose-ranging study. J. Thromb. Haemost. 6, 1313–1318 (2008).
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Gregory Lip is a consultant for Bayer, has been on the speaker's bureau/received honoraria, and has received research grants from Bayer. The other authors declare no competing interests.
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Tapp, L., Wrigley, B. & Lip, G. Oral factor Xa inhibitors in acute coronary syndromes. Nat Rev Cardiol 6, 619–620 (2009). https://doi.org/10.1038/nrcardio.2009.160
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DOI: https://doi.org/10.1038/nrcardio.2009.160