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Comprehensive Review of Antiplatelet Therapy in Secondary Prevention of Myocardial Infarction: Mechanisms, Clinical

May Thu Kyaw1,2, Arkar Moe2

  • 1Internal Medicine, University of Medicine 2, Yangon, Myanmar.

Cardiovascular Therapeutics
|June 2, 2026
PubMed

Insights

Atherosclerotic cardiovascular disease (ASCVD) management relies on antiplatelet therapy to prevent recurrent myocardial infarction (MI). Optimal therapy choice and duration are individualized based on patient risk factors and comorbidities.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis

Background:

  • Atherosclerotic cardiovascular disease (ASCVD), especially myocardial infarction (MI), is a major global health burden.
  • MI pathophysiology involves plaque rupture, thrombus formation, and myocardial necrosis, leading to significant mortality and morbidity.
  • Despite advances, recurrent ischemic events and stent thrombosis remain clinical challenges.

Purpose of the Study:

  • To review the mechanisms of thrombosis in MI.
  • To explore the role of antiplatelet therapy in secondary prevention post-MI.
  • To discuss clinical evidence, controversies, and emerging strategies in antiplatelet therapy.

Main Methods:

  • Literature review of clinical trial data.
  • Analysis of pharmacological profiles, efficacy, and safety of antiplatelet agents.
  • Examination of guideline recommendations and special population applications.

Main Results:

  • Antiplatelet therapy (aspirin and P2Y12 inhibitors) is crucial for secondary prevention after MI.
  • Individualized antiplatelet therapy selection and duration are necessary based on patient-specific factors.
  • Emerging strategies like biomarker-guided and genotype-guided therapy are being explored.

Conclusions:

  • Effective secondary prevention with individualized antiplatelet therapy is key to improving long-term prognosis after MI.
  • Understanding antiplatelet agent profiles, efficacy, and safety is vital for clinical decision-making.
  • Further research into novel therapeutic strategies is warranted to address knowledge gaps.

Keywords:
P2Y12 inhibitorsantiplatelet therapyclinical guidelineshigh on-treatment platelet reactivitymyocardial infarctionrisk stratificationsecondary prevention

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