[Optimizing antithrombotic therapy in non-ST-elevation acute coronary syndrome].

The acute coronary syndromes (i.e., ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, and unstable angina) share a common pathophysiology: the rupture or breakdown of atheromatous plaque superimposed on intracoronary thrombosis (i.e., atherothrombosis). The aim of this review article was to summarize developments occurring during the last year in antithrombotic therapy for non-ST-segment elevation acute coronary syndromes. Four specific issues are considered: pretreatment with clopidogrel before percutaneous coronary intervention, antiplatelet resistance, indications for glycoprotein IIb/IIIa inhibitors in patients pretreated with clopidogrel, and the role of bivalirudine and fondaparinux in the treatment of these patients.