부산대학교 도서관

Atherothrombosis is the central pathological process in acute coronary syndromes (ACS). Antithrombotic therapy is, therefore, a cornerstone of ACS treatment. As soon as ACS is suspected, aspirin should be commenced to reduce the risk of major adverse cardiovascular events. Addition of an oral P2Y12 inhibitor further reduces risk. Parenteral anticoagulation is indicated for any patient undergoing percutaneous coronary intervention (PCI) or thrombolysis, and for patients with non-ST elevation ACS where an early invasive treatment strategy is not pursued. In some cases of PCI for ST-elevation myocardial infarction, a platelet glycoprotein inhibitor may be utilized. Where timely primary PCI cannot be performed for ST-elevation myocardial infarction, thrombolysis with a tissue plasminogen activator may be recommended. Where there is an additional requirement for oral anticoagulation, in general patients treated by PCI should receive a short period of aspirin plus P2Y12 inhibitor plus oral anticoagulation before stopping aspirin, and then receive oral anticoagulation alone from 1 year.