title: Oral antiplatelet agents in ACS: from pharmacology to clinical differences.
abstract: Antiplatelet agents play an essential role in the treatment of acute coronary syndrome (ACS). Numerous clinical trials have established the value of antiplatelet therapies for ACS. Aspirin (ASA), thienopyridines and GP IIb/IIIa antagonists comprise the major classes of antiplatelet therapies demonstrated to be of benefit in the treatment of ACS. Thienopyridines are a class of drugs that function via inhibition of the adenosine diphosphate (ADP) P2Y12 platelet receptors. Currently, clopidogrel, a second generation thienopyridine, is the main drug of choice and the combination of aspirin and clopidogrel is administered orally for the treatment of ACS. Recently, a third generation of thienopyridines has been introduced represented by prasugrel that has demonstrated promising results in ACS patients treated with percutaneous coronary intervention (PCI). A number of nonthienopyridine oral antiplatelet drugs are under development, and one of them, ticagrelor has already been tested in a major phase III clinical trial, PLATO, with the inclusion of a broad spectrum of patients with ACS. The present review aims to discuss the present knowledge about the safety and efficacy of oral antiplatelet treatment of patients with ACS.
authors.affiliation: Department of Medicine, Oslo University Hospital and Oslo University, 0514 Oslo, Norway. stefan.agewall@medisin.uio.no
authors.forename: S
authors.initials: S
authors.lastname: Agewall
authors.forename: L
authors.initials: L
authors.lastname: Badimon
authors.forename: L
authors.initials: L
authors.lastname: Drouet
authors.forename: T
authors.initials: T
authors.lastname: Eschenhagen
authors.forename: S
authors.initials: S
authors.lastname: Husted
authors.forename: T
authors.initials: T
authors.lastname: Simon
authors.forename: G
authors.initials: G
authors.lastname: Steg
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D000284:Administration, Oral; D001792:Blood Platelets / Q000502:physiology; D002986:Clinical Trials as Topic; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D058919:Purinergic P2 Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D058924:Thienopyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D058919:Purinergic P2 Receptor Antagonists; D058924:Thienopyridines