Abstract
Considering the previously discussed in vitro and in vivo models, the past decade also witnessed major advances in oral antiplatelet therapies beyond aspirin and clopidogrel, which have been the mainstay for the past decade of antiplatelet management in acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI). However, there is still a need for clinical development of newer and more potent antiplatelet drugs because atherothrombotic events continue to occur in a relevant proportion of populations despite this combination of aspirin and clopidogrel. Two of these drugs, prasugrel and ticagrelor, have been recently approved for clinical use. Other antiplatelet strategies are in clinical development.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References and Further Reading
Aspirin in Primary Prevention of Cardiovascular Diseases
Antithrombotic Trialists’ (ATT) Collaboration (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data. Lancet 373:1849–1860
Dual Antiplatelet Therapy and Increased Risks of Bleeding
Serebruany VL, Malinin AI, Ferguson JJ, Vahabi J, Atar D, Hennekens CH (2008) Bleeding risks of combination vs. single antiplatelet therapy: a meta-analysis of 18 randomized trials comprising 129 314 patients. Fundam Clin Pharmacol 22:315–321
Aspirin + Dipyrimadole: Second European Stroke Study (ESPS-2)
Diener HC, Cunha L, Forbes C, Sivenius J, Smets P, Lowenthal A (1996) European stroke prevention study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 143(1–2):1–13
Clopidogrel + Aspirin
Bhatt DL, Fox KA, Hacke W, Berger PB, Black HR, Boden WE, Cacoub P, Cohen EA, Creager MA, Easton JD, Flather MD, Haffner SM, Hamm CW, Hankey GJ, Johnston SC, Mak KH, Mas JL, Montalescot G, Pearson TA, Steg PG, Steinhubl SR, Weber MA, Brennan DM, Fabry-Ribaudo L, Booth J, Topol EJ, CHARISMA Investigators (2006) Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 54:1706–1717
Chen ZM, Jiang LX, Chen YP, Xie JX, Pan HC, Peto R, Collins R, Liu LS, COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) Collaborative Group (2005) Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 366:1607–1621
Gurbel PA, Bliden KP, Hiatt BL, O’Connor CM (2003) Clopidogrel for coronary stenting: Response variability, drug resistance, and the effect of pretreatment platelet reactivity. Circulation 107:2908–2913
Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK, Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators (2001) Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345:494–502
Prasugrel
Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, Neumann F-J, Ardissino D, De Servi S, Murphy SA, Riesmeyer J, Weerakkody G, Gibson CM, Antman EM, For the TRITON–TIMI 38 Investigators (2007) Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357:2001–2015
Ticagrelor
Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, Horrow J, Husted S, James S, Katus H, Mahaffey KW, Scirica BM, Skene A, Steg PG, Storey RF, Harrington RA, For the PLATO Investigators (2009) Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 361:1045–1057
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this entry
Cite this entry
Mousa, S.A. (2016). Advances in Antiplatelets. In: Hock, F. (eds) Drug Discovery and Evaluation: Pharmacological Assays. Springer, Cham. https://doi.org/10.1007/978-3-319-05392-9_150
Download citation
DOI: https://doi.org/10.1007/978-3-319-05392-9_150
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-05391-2
Online ISBN: 978-3-319-05392-9
eBook Packages: Biomedical and Life SciencesReference Module Biomedical and Life Sciences