Anticoagulant Therapy in Acute Coronary Syndromes with Focus on Fondaparinux

Acute coronary syndromes (ACS) result from the rupture or erosion of an unstable atherosclerotic plaque in a major epicardial coronary vessel. This leads to activation of platelet functions and the coagulation cascade, leading to thrombus formation, coronary occlusion and/or distal thrombus embolisation. This process gives rise to acute myocardial ischemia, myocardial infarction (MI),ventricular arrhythmias and possibly death.The therapeutic armamentarium for ACS with or without ST segment elevation includes antiplatelet therapy, anticoagulants, reperfusion in ST elevation infarction (either by pharmacological treatment or mechanical reperfusion, or both), or revascularisation with percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) in non-ST segment elevation ACS.