What is the role of anticoagulant therapy in the acute management of ST-elevation myocardial infarction (STEMI) (MI, heart attack), and what are the available options?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Anticoagulant agents are an important adjunctive therapy for reperfusion therapy regardless of the strategy chosen (ie, whether it is primary PCI or fibrinolysis therapy). Different anticoagulation agents are available; the utility of each agent depends on the clinical context, taking into account the method of reperfusion.

For primary PCI, unfractionated heparin (UFH), bivalirudin, [2, 4]  and low molecular weight heparin (LMWH) (eg, enoxaparin [4] ) are the available options. Fondaparinux is not used in this setting because of the increased risk of catheter thrombosis. [87]


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