A new generation of antiplatelet agents.
OBJECTIVE
Since the development and market entry of clopidogrel, a platelet ADP blocker, physicians have had few new antiplatelet options available to them for the treatment of acute and chronic coronary disease, specifically in the setting of acute coronary syndromes, percutaneous coronary intervention, and chronic stent management. Over the years, limitations of current antiplatelet regimens have emerged, establishing a need for novel antiplatelet drugs. This article discusses potential new targets for platelet inhibition and reviews innovative antiplatelet therapies under investigation.


RESULTS
There are five main categories of antiplatelet therapies currently undergoing clinical study, consisting of the thienopyridines (P2Y12 receptor antagonists), cyclopentyltriazolopyrimidines (P2Y12 receptor antagonists), anti-von Willebrand factor aptamers, thrombin receptor (protease-activated receptor-1) antagonists, and thromboxane receptor antagonists. Early studies of these agents are discussed.


CONCLUSIONS
Each of these new antiplatelet therapies has a unique profile that is aimed at improving clinical response with hopes of incremental efficacy and decreased complications, specifically bleeding.
Sellers
Matthew B
MB
Duke Clinical Research Institute, Durham, NC 27705, USA.
Tricoci
Pierluigi
P
Harrington
Robert A
RA
D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use; D018048:Receptors, Purinergic P2; D058925:Receptors, Purinergic P2Y12; D018179:Receptors, Thrombin / Q000037:antagonists & inhibitors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014841:von Willebrand Factor / Q000037:antagonists & inhibitors / Q000187:drug effects
C548576:P2RY12 protein, human; D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; D018048:Receptors, Purinergic P2; D058925:Receptors, Purinergic P2Y12; D018179:Receptors, Thrombin; C446540:thienopyridine; D014841:von Willebrand Factor; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin