title: New antiplatelet agents: why they are needed.
abstract: Despite recent advances in the treatment of acute coronary syndromes (ACS), including dual antiplatelet therapy with aspirin and a thienopyridine during the acute phase and for secondary prevention, this condition remains a leading cause of morbidity and mortality. The limitations of the currently available antiplatelet agents have triggered the development of newer drugs. In this review we summarize the mechanisms of actions and results of current clinical trials of novel antiplatelet agents. These include prasugrel, a thienopyridine prodrug which has a mechanism similar to that of clopidogrel but superior pharmacokinetic features; ticagrelor, a non-thienopyridine that binds reversibly to the platelet P2Y(12) receptor; cangrelor, an intravenously administered analog of ticagrelor; the thrombin receptor antagonist SCH 53048; and terutroban (S18886), a thromboxane A(2) receptor inhibitor.
authors.affiliation: Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine, University Hospital of Parma, Italy. piermannuccio.mannucci@unimi.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchini
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy; D000241:Adenosine / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D000249:Adenosine Monophosphate / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007783:Lactones / Q000494:pharmacology / Q000627:therapeutic use; D009281:Naphthalenes / Q000494:pharmacology / Q000627:therapeutic use; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000068799:Prasugrel Hydrochloride; D011355:Prodrugs / Q000494:pharmacology / Q000627:therapeutic use; D011422:Propionates / Q000494:pharmacology / Q000627:therapeutic use; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use; D013876:Thiophenes / Q000494:pharmacology / Q000627:therapeutic use; D000077486:Ticagrelor
chemical_list: D007783:Lactones; D009281:Naphthalenes; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D011355:Prodrugs; D011422:Propionates; D011725:Pyridines; D013876:Thiophenes; D000249:Adenosine Monophosphate; C117446:cangrelor; C501362:terutroban; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; C530299:vorapaxar