Antiplatelet therapies: drug interactions in the management of vascular disorders

Antiplatelet drugs represent a key class of drugs that are of proven value in arterial thromboembolic disorders. There is a need for effective, safe antiplatelet agents or their combinations to provide predictable therapeutic benefit, dosage flexibility, and unique pharmacologic profiles, such as rapid onset in acute thrombotic states, as well as sustained antiplatelet effects in chronic platelet-activating states (e.g., post-stent placement). Aspirin, clopidogrel, or their combination have shown improved clinical outcomes in certain unique settings, and the search for additional antiplatelet agents is ongoing. Current studies suggest that combination antiplatelet therapy with existing agents is best considered a use-adapted strategy, with the greatest clinical benefit of combination therapy realized in acute, platelet-activating, and prothrombotic states.