Future directions in thrombolysis.
An extensive body of research conducted in the past 25 years has helped foster understanding of the mechanisms and pathogenesis of the acute coronary syndromes and occlusive disease. Thus, it is well established that thrombosis is caused by vascular injury and that immediate lysis of the arterial thrombus and subsequent prevention of thrombotic reocclusion are critical to the treatment of these disorders. Remarkable progress in the understanding of the biological and molecular mechanisms involved in vascular-wall-platelet interactions, platelet-platelet interactions, and coagulation has led to the identification of multiple targets for drug discovery and the development of numerous antithrombotic drugs. The purpose of this article is to review emerging antithrombotic therapies, introduce potential future molecular targets for drug discovery efforts, and discuss novel strategies for managing patients with coronary disease.
Willerson
J T
JT
Department of Medicine, University of Texas Medical School at Houston 77225, USA.
Zoldhelyi
P
P
D000077144:Clopidogrel; D003327:Coronary Disease / Q000188:drug therapy*; D003328:Coronary Thrombosis / Q000209:etiology* / Q000503:physiopathology; D051546:Cyclooxygenase 2; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D007527:Isoenzymes; D008565:Membrane Proteins; D019007:P-Selectin; D015539:Platelet Activation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D011451:Prostaglandin-Endoperoxide Synthases; D015912:Thrombolytic Therapy / Q000639:trends*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D004791:Enzyme Inhibitors; D005343:Fibrinolytic Agents; D007527:Isoenzymes; D008565:Membrane Proteins; D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077144:Clopidogrel; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D013988:Ticlopidine