In the case of a 62-year-old woman with NSTEMI choosing a conservative treatment strategy, what is the best antithrombotic regimen besides aspirin?

The selection of an antithrombotic regimen for a patient with NSTEMI who is being managed with a conservative strategy is crucial for optimizing outcomes while minimizing the risk of complications. The use of enoxaparin and ticagrelor represents a compelling choice because both agents have demonstrated efficacy in the setting of acute coronary syndromes.

Enoxaparin, a low molecular weight heparin, provides effective anticoagulation, reduces the risk of thrombus formation, and is generally well-tolerated. It can be administered subcutaneously and does not require routine monitoring of coagulation parameters, making it convenient for outpatient settings where patients may not require invasive measures.

Ticagrelor, a P2Y12 inhibitor, has been shown in clinical trials to have superior outcomes compared to clopidogrel, particularly in terms of reducing cardiovascular events. It also offers a rapid onset of action, which is beneficial in the acute phase of NSTEMI management. Additionally, ticagrelor has the advantage of a reversible mechanism of action, providing a more flexible approach in adjusting therapy if necessary.

Choosing enoxaparin in combination with ticagrelor aligns well with current guidelines, which emphasize the dual antiplatelet therapy along