Anticoagulants and platelet inhibitors in patients with acute coronary syndromes. Pros and cons

Blood-thinning drugs are an integral component of the guideline-conform acute treatment of patients with acute coronary syndromes. This treatment includes anticoagulants as well as platelet aggregation inhibitors. Because inhibition of blood coagulation automatically leads to an increased risk of bleeding and can cause potentially severe complications, the indications for administration of blood-thinning medication are complex. This article discusses the pros and cons of administration of anticoagulants and platelet inhibitors in accordance with the current treatment guidelines based on a typical patient with an acute coronary syndrome. Included are acetylsalicylic acid, heparin and P2Y12 inhibitors, such as clopidogrel and ticagrelor as well as thrombolysis with recombinant plasminogen activator in a prehospital setting.