Related Experiment Video

Updated: Dec 30, 2025

Ferric Chloride-induced Murine Thrombosis Models
10:37

Ferric Chloride-induced Murine Thrombosis Models

Published on: September 5, 2016

22.8K

Dual-pathway inhibition for secondary and tertiary antithrombotic prevention in cardiovascular disease

Davide Capodanno1, Deepak L Bhatt2, John W Eikelboom3

  • 1Division of Cardiology, C.A.S.T., P.O. 'G. Rodolico', Azienda Ospedaliero-Universitaria 'Policlinico-Vittorio Emanuele', University of Catania, Catania, Italy.

Nature Reviews. Cardiology
|January 19, 2020
PubMed

Insights

Balancing bleeding and ischaemia risks in cardiovascular disease patients is challenging. Dual-pathway inhibition, combining antiplatelet and anticoagulant drugs, offers a novel strategy to prevent atherothrombotic events.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Thrombosis Research

Background:

  • Antiplatelet therapies have improved cardiovascular disease (CVD) outcomes but leave residual ischaemic risk.
  • Balancing ischaemia and bleeding risks remains a significant clinical challenge.
  • Novel strategies are needed to enhance atherothrombotic event prevention beyond platelet inhibition.

Purpose of the Study:

  • To review the pharmacological rationale and clinical development of dual-pathway inhibition strategies.
  • To explore combining antiplatelet agents with non-vitamin K antagonist oral anticoagulants (NOACs).
  • To assess the potential for preventing atherothrombotic events in various CVD manifestations.

Main Methods:

  • Review of emerging pharmacological data on dual-pathway inhibition.
  • Analysis of clinical trial data for combined antiplatelet and anticoagulant therapies.
  • Examination of mechanisms targeting both platelet aggregation and fibrin formation.

Main Results:

  • NOACs attenuate fibrin formation by inhibiting factor Xa or thrombin.
  • Dual-pathway inhibition strategies are being developed to address residual ischaemic risk.
  • These strategies aim for improved prevention of atherothrombotic events with acceptable bleeding risk.

Conclusions:

  • Dual-pathway inhibition represents a promising approach for managing atherothrombotic risk in CVD.
  • Combining antiplatelet therapy with anticoagulation (e.g., NOACs) warrants further investigation.
  • This strategy may offer enhanced protection against ischaemic events in coronary, cerebrovascular, and peripheral artery disease.

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.7K
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.3K

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
234
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.9K
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.5K
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
990
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
191
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
195