A focus on direct oral anticoagulants: "old" and possible new indications and efforts for a better clinical management

Both platelets and coagulation play key roles in initiation, amplification, and perpetuation of acute coronary syndromes (ACS). Nonetheless, patients with ACS frequently have recurrent ischemic events despite the use of currently recommended dual antiplatelet therapy, revascularization procedures as appropriate, and other evidence-based secondary preventive measures. Numerous antithrombotic cocktails including oral anticoagulants (OACs) with or without aspirin have been tested in large clinical trials with the goal of further reduction of ischemia and bleeding risk.