Antiplatelet agents in cardiology: the choice of therapy.
BACKGROUND
The platelet-rich, intracoronary thrombus is central to the pathogenesis of acute myocardial infarctions, unstable angina, and the majority of complications of percutaneous coronary interventions. Until recently, aspirin was the only antiplatelet agent available to help prevent or treat these events. Over the past several years, there has been a substantial expansion in our antiplatelet armamentarium as well as in our understanding of the clinical importance of antiplatelet therapy in limiting the complications of intracoronary thrombosis. Because of this, it is likely that over the coming years, the use of antiplatelet therapies will continue to expand, and it may not be unusual for a surgeon to encounter a patient being treated with two or even three platelet inhibitors.


CONCLUSIONS
This review will highlight the benefits and limitations of the currently available antiplatelet regimens: aspirin, thienopyridines (ticlopidine and clopidogrel), and the platelet glycoprotein IIb/IIIa inhibitors.
Steinhubl
S R
SR
Department of Cardiology, Wilford Hall Medical Center, Lackland AFB, Texas 78236-5300, USA.
D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003327:Coronary Disease / Q000628:therapy*; D003328:Coronary Thrombosis / Q000517:prevention & control*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin