Antiplatelet agents in acute coronary syndromes

The platelet plays an essential role in atherothrombosis. Clinically, platelet-rich thrombi underlie acute coronary syndromes (ACSs). Current therapies have improved outcomes, however, often at the expense of increased risk of bleeding. With the increase in our understanding of the underlying pathophysiology of ACSs, newer targets for antiplatelet therapies continue to emerge. Novel antiplatelet agents may provide even greater reductions in ischemic events with the potential for less bleeding. This article reviews the evidence for current antiplatelet agents in ACSs as well as for the newer agents in later phases of clinical testing.