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Published on: February 28, 2012
Antiplatelet agents in cardiology: the choice of therapy
1Department of Cardiology, Wilford Hall Medical Center, Lackland AFB, Texas 78236-5300, USA.
Insights
Platelet-rich thrombus drives heart attacks and complications from coronary interventions. New antiplatelet drugs, including aspirin, thienopyridines, and glycoprotein IIb/IIIa inhibitors, offer expanded treatment options.
Area of Science:
- Cardiovascular Medicine
- Hematology
Background:
- Intracoronary thrombus, rich in platelets, is a key factor in acute myocardial infarctions, unstable angina, and percutaneous coronary intervention complications.
- Aspirin was historically the sole antiplatelet agent for managing these conditions.
- Recent advancements have significantly expanded antiplatelet options and understanding of their clinical impact.
Purpose of the Study:
- To review the benefits and limitations of current antiplatelet therapies.
- To inform clinicians about the evolving landscape of antiplatelet treatment.
Main Methods:
- Literature review of antiplatelet agents.
- Analysis of clinical significance and complications of intracoronary thrombosis.
Main Results:
- The review covers aspirin, thienopyridines (ticlopidine, clopidogrel), and glycoprotein IIb/IIIa inhibitors.
- The expanding role of dual and triple antiplatelet therapy is acknowledged.
Conclusions:
- Current antiplatelet regimens offer diverse benefits and limitations.
- Understanding these agents is crucial for managing thrombotic cardiovascular events.
Background:
The platelet-rich, intracoronary thrombus is central to the pathogenesis of acute myocardial infarctions, unstable angina, and the majority of complications of percutaneous coronary interventions. Until recently, aspirin was the only antiplatelet agent available to help prevent or treat these events. Over the past several years, there has been a substantial expansion in our antiplatelet armamentarium as well as in our understanding of the clinical importance of antiplatelet therapy in limiting the complications of intracoronary thrombosis. Because of this, it is likely that over the coming years, the use of antiplatelet therapies will continue to expand, and it may not be unusual for a surgeon to encounter a patient being treated with two or even three platelet inhibitors.
Conclusions:
This review will highlight the benefits and limitations of the currently available antiplatelet regimens: aspirin, thienopyridines (ticlopidine and clopidogrel), and the platelet glycoprotein IIb/IIIa inhibitors.
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