Combination antithrombotic management for NON-ST segment elevation acute coronary syndromes

Patients with non-ST segment elevation acute coronary syndromes (NSTEACS) are at high risk for subsequent thrombotic events. Combination antithrombotic management with anticoagulant and antiplatelet medications can improve outcomes in these high-risk patients. If an early invasive strategy is planned, unfractionated heparin or bivalirudin are the anticoagulants of choice, whereas in those in whom an early conservative strategy is planned enoxaparin or fondaparinux may be preferred. All patients with NSTEACS should receive aspirin and continue it indefinitely unless they cannot tolerate it. A second antiplatelet agent should be administered both for an early invasive or early conservative strategy.