- NEWS . 13 Jan 2020
Prehospital management of ACS patients on long-term anticoagulant treatment is highly variable
In Germany, there is a diverse practice of emergency treatment of patients with acute coronary syndrome (ACS) under direct oral anticoagulant (DOAC) therapy when administering heparin and acetylsalicylic acid (ASA), according to a survey. Researchers in Germany wanted to determine the current practice of preclinical treatment of ACS in patients under DOAC treatment. They used an internet and paper-based survey of emergency physicians, specialists of internal medicine, anaesthesiologists, and emergency and intensive care physicians and received 284 answered questionnaires.
The findings revealed there were substantial differences in the current treatment of ACS under long-term DOAC therapy. While 39% of the respondents stated that they administer a combination treatment of heparin and acetylsalicylic acid, 36% did not administer heparin. If a dose reduction was performed, 71% answered that they reduce the heparin dosage. In addition, in cases of ST-segment elevation myocardial infarction 48% of the respondents renounced the use of heparin.
The researchers concluded that there are no uniform guidelines for the anticoagulation treatment of ACS patients, and more scientific data is needed to support evidence-based practice.
Schneck E, et al. [Prehospital management of acute coronary syndrome in patients on long-term direct oral anticoagulant treatment]. Anaesthesist 2019. doi: 10.1007/s00101-019-00710-8. [Epub ahead of print]