Abstract
Objective: Propose a systematic review about anticoagulants in acute coronary syndromes (ACS). Methods: Research was conducted on electronic databases to find randomized controlled studies or retrospective or prospective observational studies that addressed the use of oral anticoagulants in patients with acute coronary syndrome. The research included articles published from 2010 to 2019, in English or Portuguese. The selection was carried out by two independent evaluators. Results: According to the methodological proposal, an average age of over 60 years was found. The most common clinical indication for oral anticoagulants was patients who underwent percutaneous coronary intervention as a result of ACS and evolved with atrial fibrillation, the most used being Warfarin. The use of triple antithrombotic therapy (anticoagulant + warfarin + clopidogrel) was associated with an increased risk of bleeding with similar efficacy when compared to the use of aspirin and clopidogrel alone. Final considerations: The use of triple therapy must take into account factors about the hemorrhagic risk so that its benefits outweigh the risks.