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Updated: May 30, 2026
Ferric Chloride-induced Murine Thrombosis Models
Published on: September 5, 2016
Atherothrombosis and the role of antiplatelet therapy
Ph G Steg1, S H Dorman, P Amarenco
1INSERM U-698, Université Paris-Diderot, Assistance Publique-Hôpitaux de Paris, Paris, France. gabriel.steg@bch.aphp.fr
Insights
Antiplatelet therapy offers benefits in secondary prevention of atherothrombosis, particularly for acute coronary syndromes and cerebrovascular events. Routine use in primary prevention requires careful individual risk assessment due to bleeding concerns.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Pharmacology
Background:
- Atherothrombosis is a significant global health issue, often asymptomatic until complicated by thrombosis, leading to severe vascular events.
- Platelets are crucial in chronic atherosclerotic disease progression and acute atherothrombotic events.
- Numerous antiplatelet agents are under investigation for primary and secondary prevention strategies.
Purpose of the Study:
- To review the evidence for antiplatelet agents in the primary and secondary prevention of atherothrombotic events.
- To evaluate the efficacy and safety of single versus dual antiplatelet therapy across different vascular beds.
- To inform clinical decision-making regarding the use of antiplatelet drugs in diverse patient populations.
Main Methods:
- Systematic review of clinical trials investigating antiplatelet agents.
- Analysis of data on efficacy in preventing recurrent cardiovascular and cerebrovascular events.
- Assessment of bleeding risk associated with antiplatelet therapies.
Main Results:
- Dual antiplatelet therapy (DAPT) is standard for acute coronary syndromes (ACS) and beneficial in secondary cerebrovascular prevention.
- Aspirin monotherapy is effective for secondary prevention in cerebrovascular disease; DAPT offers marginal benefits.
- Evidence for routine DAPT in chronic stable coronary disease is lacking.
- In primary prevention, antiplatelet use is recommended only for high-risk individuals where benefits outweigh bleeding risks.
Conclusions:
- Antiplatelet therapy plays a vital role in secondary prevention of atherothrombosis, with specific regimens tailored to clinical scenarios.
- The use of antiplatelet agents in primary prevention requires careful individualized risk-benefit assessment.
- Ongoing research into novel antiplatelet agents continues to evolve treatment paradigms for atherothrombosis.
Abstract:
Atherothrombosis remains a major global public health problem. Chronic atherosclerotic disease is often clinically silent and coexists across vascular beds, but when complicated by thrombosis can result in acute coronary syndrome, stroke, transient ischaemic attack and critical limb ischaemia. Platelets play a role in the development of chronic atherosclerotic disease and are a key mediator of clinical events in atherothrombosis. Numerous trials have examined the role of antiplatelet agents in primary and secondary prevention and several new antiplatelet drugs are under development. In secondary prevention, there is evidence of clear benefit of single and in some cases dual antiplatelet therapy in the prevention of recurrent cerebro-vascular complications. Dual antiplatelet therapy has emerged as the standard of care in acute coronary syndromes, with aspirin typically being used in combination with clopidogrel or one of the newer more potent antiplatelet agents. Conversely, in chronic stable coronary disease, no benefit has yet been convincingly demonstrated from dual antiplatelet therapy. In cerebro-vascular disease, aspirin monotherapy remains the cornerstone of prevention of recurrent events, with clopidogrel or the combination of aspirin and dipyridamole being only modestly more efficacious. In primary prevention, the evidence for the routine use of aspirin or any other antiplatelet agent is mixed and suggests this should only be considered on an individual basis in high-risk groups where the thrombotic risk outweighs the risk of major bleeding complications.
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