Management of Patients with Acute Coronary Syndromes

Despite important pharmacokinetic and biological advantages of direct thrombin inhibitors over heparin, early randomised trials failed to demonstrate a clear net clinical benefit of these agents compared with heparin because of a higher bleeding risk, particularly with hirudin, and only modest efficacy gains. More recently, however, a systematic review of the direct thrombin inhibitor trials based on individual patient data as well as the …