Antiplatelet drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).
This article about currently available antiplatelet drugs is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). It describes the mechanism of action, pharmacokinetics, and pharmacodynamics of aspirin, reversible cyclooxygenase inhibitors, thienopyridines, and integrin alphaIIbbeta3 receptor antagonists. The relationships among dose, efficacy, and safety are thoroughly discussed, with a mechanistic overview of randomized clinical trials. The article does not provide specific management recommendations; however, it does highlight important practical aspects related to antiplatelet therapy, including the optimal dose of aspirin, the variable balance of benefits and hazards in different clinical settings, and the issue of interindividual variability in response to antiplatelet drugs.
From the Catholic University School of Medicine, Rome, Italy. Electronic address: carlo.patrono@rm.unicatt.it.
Carlo
C
Patrono
Clinical Trial Service Unit, University of Oxford, Oxford, UK.
Colin
C
Baigent
Hamilton Civic Hospitals, Henderson Research Centre, Hamilton, ON, Canada.
Jack
J
Hirsh
Seattle VA Medical Center, Seattle, WA.
Gerald
G
Roth
D001241:Aspirin / Q000493:pharmacokinetics / Q000494:pharmacology; D016861:Cyclooxygenase Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology*; D019317:Evidence-Based Medicine; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D011725:Pyridines / Q000493:pharmacokinetics / Q000494:pharmacology*
D016861:Cyclooxygenase Inhibitors; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011725:Pyridines; C446540:thienopyridine; D001241:Aspirin