The role of antiplatelet therapy in the management of acute coronary syndromes.
The benefit of aspirin use in the emergent care of acute coronary syndromes (ACS) has been well-established. Recent studies have further demonstrated the importance of antiplatelet therapy in the acute setting, primarily with the use of intravenous glycoprotein IIb/IIIa receptor inhibitors. Aspirin and the thienopyridines (ticlopidine and clopidogrel) are oral antiplatelet agents that interfere with platelet activation in complementary, but separate pathways. Combination therapy of aspirin with other antiplatelet agents has demonstrated a benefit for the management of ACS. This article reviews the pathophysiology of platelet activation in ACS, landmark trials regarding antiplatelet agents, and the current recommendations for the use of both intravenous and oral antiplatelet agents in the management of patients with ACS.
Volturo
Gregory A
GA
University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA. volturog@ummhc.org
Mazzola
Jennifer L
JL
Przylenk
Karin
K
D000208:Acute Disease; D000284:Administration, Oral; D002986:Clinical Trials as Topic; D006801:Humans; D007262:Infusions, Intravenous; D009203:Myocardial Infarction / Q000517:prevention & control*; D015539:Platelet Activation / Q000187:drug effects / Q000502:physiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D013927:Thrombosis / Q000139:chemically induced / Q000150:complications
D010975:Platelet Aggregation Inhibitors