Tag Archives: acute coronary syndrome (ACS)

Introduction Dual antiplatelet therapy (DAPT) comprises a combination of aspirin and thienopyridine agents, such as clopidogrel, prasugrel and ticagrelor. DAPT is the cornerstone of treatment of patients presenting with acute coronary syndrome (ACS), undergoing either medical therapy alone or percutaneous coronary intervention (PCI).1,2 There has been considerable progress in the treatment of ACS with the advent of more potent agents, in addition to therapeutic anticoagulation. DAPT has contributed to improved outcomes in patients presenting with ACS, with numerous studies showing a marked reduction in major adverse cardiovascular and cerebr

Introduction Control of hypercholesterolaemia has been established as a highly effective first-line management in acute coronary syndrome (ACS) patients.1,2 Data from a meta-analysis of randomised-controlled trials demonstrated that for each 1 mmol/L reduction in low-density lipoprotein (LDL)-cholesterol (LDL-C), statins reduced major cardiovascular (CV) events (myocardial infarction [MI], CV death, any stroke or coronary revascularisation) by an estimated 22%.3 National Institute for Health and Care Excellence (NICE) and international guidelines recommend fasting lipid profiles before, and within three months following, the initiation of hi

Introduction Dual antiplatelet therapy (DAT) with aspirin and clopidogrel is recommended for up to one year following acute coronary syndrome (ACS) in order to reduce the risk of further cardiac events.1,2 Gastrointestinal bleeding is the main hazard of this treatment; however, although the incidence of bleeding is low, it results in significantly increased morbidity and mortality in these patients,3-5 and proton pump inhibitors (PPIs) are often prescribed to selective patients to reduce this risk. PPIs act by reducing the secretion of gastric acid, neutralising gastric pH, increasing clot formation and decreasing the lysis of blood clots. Th