الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Novel oral anticoagulants, used as add-on therapy, can reduce future cardiovascular events in ACS patients but the potential for increased bleeding risk has to be carefully considered. Results for various agents, even in the same class, are mixed.
Darexaban and apixaban increased bleeding and darexaban has been withdrawn. Apixaban and the PAR 1 antagonist, vorapaxar, both increased major bleeding without reduction in ischemic events. Dabigatran remains to be fully evaluated.
In contrast, rivaroxaban appears to reduce cardiovascular events at a cost of increased major bleeding. Atopaxar appears to improve surrogates of myocardial ischemia without increasing the risk of significant bleeding, but has not been evaluated in terms of ischemic event reduction and larger trials are required.
It is likely that patients at high risk of thrombosis are the ones that will benefit the most. Close attention to bleeding and careful monitoring of renal and liver function, and perhaps platelet function tests may help identify patients at high risk of bleeding and thus target therapy at those with high thrombotic risk and low bleeding risk, making the use of these drugs more safe and efficacious.