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Impact of antiplatelet therapy in heart disease

Giulia Renda1, Raffaele de Caterina

  • 1Institute of Cardiology and Center of Excellence on Aging, G. d'Annunzio University, Chieti, Italy.

Advances in Cardiology
|August 22, 2012
PubMed

Insights

Antiplatelet agents like aspirin and P2Y12 inhibitors are crucial for preventing heart attacks and managing cardiovascular disease after stenting. Their role in stroke prevention for atrial fibrillation is now secondary to anticoagulants.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Internal Medicine

Background:

  • Platelet activation is a key factor in the pathophysiology of acute coronary syndromes (ACS).
  • Antiplatelet agents are fundamental in cardiovascular therapy for primary and secondary prevention.
  • Current guidelines recommend aspirin for all patients and P2Y12 inhibitors for secondary prevention post-ACS, particularly after stent implantation.

Purpose of the Study:

  • To provide a comprehensive overview of antiplatelet agent utilization in heart disease management.
  • To discuss the role of various antiplatelet drugs, including aspirin, P2Y12 inhibitors, and glycoprotein IIb/IIIa antagonists.
  • To highlight the evolving role of antiplatelet therapy in stroke prevention for patients with atrial fibrillation.

Main Methods:

  • Review of current clinical practices and guidelines regarding antiplatelet therapy in cardiovascular diseases.
  • Discussion of specific antiplatelet agents: aspirin, clopidogrel, prasugrel, ticagrelor, ticlopidine, and abciximab.
  • Comparative analysis of antiplatelet therapy versus anticoagulation for stroke prevention in atrial fibrillation.

Main Results:

  • Aspirin combined with a P2Y12 inhibitor is standard for secondary prevention after ACS and stenting.
  • Glycoprotein IIb/IIIa antagonists may be considered in high-risk ACS treated with percutaneous coronary interventions.
  • The use of antiplatelet therapy for stroke prevention in atrial fibrillation has decreased, favoring anticoagulants.

Conclusions:

  • Antiplatelet therapy remains a cornerstone in managing acute coronary syndromes and preventing cardiovascular events.
  • The choice and duration of antiplatelet therapy are tailored to specific clinical scenarios and patient risk.
  • Anticoagulation is now preferred over antiplatelet therapy for stroke prevention in most atrial fibrillation patients.

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