title: Oral antiplatelet therapy for acute coronary syndromes: aspirin, P2Y12 inhibition and thrombin receptor antagonists.
abstract: The platelet is central to the pathophysiology of acute coronary syndromes (ACS) via its direct participation in the formation of the thrombotic occlusion and its participation in the coagulation cascade that results in the formation of thrombin. Antiplatelet therapy is a cornerstone of therapy in the setting of ACS. Unfortunately, many patients who receive intensive antiplatelet therapy remain at high risk for recurrent events. Current efforts to reduce this "residual risk" include lifestyle modifications, cardiac rehabilitation, and intensive therapy for dyslipidemia. Also being investigated are methods of individualizing and intensifying antiplatelet therapy. Novel compounds that promise to reduce recurrent ischemic events without an increase in bleeding events are being evaluated in clinical trials. This review summarizes ongoing efforts to improve the effectiveness of antiplatelet therapy among patients with ACS.
authors: Gill Heart Institute at University of Kentucky and Lexington Veterans Administration Hospital, Lexington, KY, USA.
authors: Alison L
authors: AL
authors: Bailey
authors: Charles L
authors: CL
authors: Campbell
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000517:prevention & control; D000284:Administration, Oral; D000818:Animals; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D058990:Molecular Targeted Therapy; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D058925:Receptors, Purinergic P2Y12 / Q000737:chemistry*; D018179:Receptors, Thrombin / Q000037:antagonists & inhibitors*; D055502:Secondary Prevention
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D058925:Receptors, Purinergic P2Y12; D018179:Receptors, Thrombin; D001241:Aspirin