title: The current state of antiplatelet therapy in acute coronary syndromes: the data and the real world.
abstract: Managing antiplatelet therapy for patients with acute coronary syndromes (ACS) is complex, and current therapy options and approaches for these patients are suboptimal. Despite the use of available antiplatelet therapies--aspirin, clopidogrel, and the parenteral glycoprotein IIb/IIIa inhibitors--recurrence of ischemic events in patients with ACS continues to rise over time. Moreover, bleeding remains an important--and often underappreciated--risk with these therapies, and national registries demonstrate that dosing of antiplatelet therapies frequently strays from evidence-based guidelines. Recent quality-improvement initiatives developed in conjunction with national registries of patients with ACS promise to improve adherence to guidelines through hospital-specific performance reports. More evidence-based use of existing and emerging antiplatelet agents has the potential to improve both ischemic and bleeding outcomes in patients with ACS.
authors.affiliation: Duke University Medical Center, Duke Clinical Research Institute, DUMC Box 3850, Durham, NC 27715, USA. john.h.alexander@duke.edu
authors.forename: John H
authors.initials: JH
authors.lastname: Alexander