Anticoagulation is a part of standard medical treatment for ACS (NSTEMI and STEMI). However if you’ve given heparin 25 times for ACS, chances are you’ve caused one major bleeding event—so the question remains: was it worth the risk?
Current AHA Guidelines
Current AHA guidelines advise administering anticoagulation use for both NSTEMI and STEMI (Class I recommendation).
- 2014 AHA/ACCF Guidelines for the Management of NSTEMI (Section 4.3) 🔗 Read the Guideline
- 2013 AHA/ACC Guidelines for the Management of STEMI (Section 4.4.2 and 5.1.4.2) 🔗 Read the Guideline
the NNT
- The NNT: Heparin for Acute Coronary Syndromes
The NNT summarizes findings from a meta-analysis of randomized controlled trials, focusing on the efficacy of heparin in reducing reinfarction and mortality. The article also delves into the associated bleeding risks, providing clinicians with a clear risk-benefit analysis.
A Deep Dive in the Literature
FOAMed explores the historical and current role of heparin in the management of acute coronary syndromes, questioning the AHA recommendations and evaluating evidence from RCTs, observational studies and systematic reviews.