The role of the novel oral anticoagulants in the secondary prevention of acute coronary syndromes.

Acute coronary syndromes continue to be a dominant cause of death worldwide. Acute therapies with potent antithrombotic agents have improved in-hospital outcomes; however, despite the use of these therapies, recurrent events continue to occur long term. Statins, renin-angiotensin inhibitors, beta-blockers, and dual antiplatelet therapy all have roles in mitigating long-term risk, but given recurrent thrombotic events on contemporary pharmacologic agents, novel therapies inhibiting thrombin formation have been explored. The intent of the current article is to review recent phase II/III clinical trials of oral anticoagulants used for the prevention of acute coronary syndromes.