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Antiplatelet therapy for coronary artery disease in 2023: current status and future prospects

Rishi Chandiramani1,2, Alessandro Spirito1, James W Johnson1

  • 1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Expert Review of Cardiovascular Therapy
|April 19, 2023
PubMed

Insights

Antiplatelet therapy is crucial for preventing ischemic events in coronary artery disease. Management now balances ischemic and bleeding risks, focusing on patient-centered care and future pharmacological advancements.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Antiplatelet therapy is fundamental in managing ischemic complications in coronary artery disease (CAD).
  • Evolving stent technology and recognition of major bleeding's impact shift focus towards balancing ischemic and bleeding risks.
  • A patient-centered approach individualizes antithrombotic regimens.

Approach:

  • This review synthesizes current evidence on antiplatelet therapy management strategies for coronary syndromes.
  • It examines the rationale, guideline recommendations, and risk assessment tools for antiplatelet use.
  • Future pharmacological directions and novel therapeutic targets are discussed.

Key Points:

  • Current antiplatelet strategies aim for an equipoise between preventing recurrent ischemic events and minimizing bleeding complications.
  • Risk scores and treatment response assessment tools aid in personalized antiplatelet regimen selection.
  • Advancements in antithrombotic agents necessitate ongoing research and validation of contemporary strategies.

Conclusions:

  • Future antiplatelet therapy for CAD will likely involve novel targets and agents.
  • Innovative regimens using existing antiplatelet drugs are being explored.
  • Further research is essential to validate and refine current antiplatelet treatment paradigms.
Abstract

Keywords:
Antiplatelet therapyP2Y12 inhibitoraspirinbleedingdual antiplatelet therapyoral anticoagulationpharmacologythrombosis

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