title: Current problems, new opportunities and future directions of anti-platelet therapy - increasing role of novel antiplatelet agents in cardiovascular diseases.
abstract: The role of antiplatelet therapy in the management of coronary artery disease and its sequalae is of great significance. Acetil Salycilic Acid (ASA) has continued to dominate the field as a potent antiplatelet agent, due to its ease of use and cost effectiveness. In addition to this, clopidogrel has also been widely used with better long term administration results in patients with atherosclerotic disease. However, interpatient variability and resistance to clopidogrel has opened the doors for further investigative research to find another agent which potentially meets the pharmacokinetic demands whilst having a satisfactory safety profile. Prasugrel and other novel nonthienopyridine derivatives are currently under investigation, with previous trials showing very reassuring outcomes. Patented inventions along with large trials have shown that prasugrel significantly reduces ischemic end points, ultimately resulting in a decrease in Myocardial infarctions, thromboocculusive episodes and death. Further studies are required to support these findings before we are aware of all clinical effects of Prasugrel.
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland. mpostula@amwaw.edu.pl
authors.forename: Marek
authors.initials: M
authors.lastname: Postuła
authors.forename: Shazia
authors.initials: S
authors.lastname: Akram
authors.forename: Fozia
authors.initials: F
authors.lastname: Akram
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000249:Adenosine Monophosphate / Q000031:analogs & derivatives / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D000077144:Clopidogrel; D006801:Humans; D007097:Imines / Q000627:therapeutic use; D007783:Lactones / Q000627:therapeutic use; D010330:Patents as Topic; D010879:Piperazines / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D000068799:Prasugrel Hydrochloride; D058919:Purinergic P2 Receptor Antagonists; D011725:Pyridines / Q000627:therapeutic use; D058925:Receptors, Purinergic P2Y12; D018179:Receptors, Thrombin / Q000037:antagonists & inhibitors; D013876:Thiophenes / Q000627:therapeutic use; D000077486:Ticagrelor; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: C540445:E 5555; D007097:Imines; D007783:Lactones; C548576:P2RY12 protein, human; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D058919:Purinergic P2 Receptor Antagonists; D011725:Pyridines; D058925:Receptors, Purinergic P2Y12; D018179:Receptors, Thrombin; D013876:Thiophenes; D000249:Adenosine Monophosphate; C117446:cangrelor; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine; C530299:vorapaxar