title: Antiplatelet therapy in acute coronary syndromes.
abstract: BACKGROUND
  Antiplatelet therapy is the cornerstone of treatment for patients with acute coronary syndromes in the acute phase and in long-term management. Over the last few years, new antiplatelet drugs have been developed and the therapeutic landscape has rapidly evolved.
  
  
  METHODS
  We review the available evidence and most recent data concerning all of the principal classes of antiplatelet agents, including aspirin, thienopyridines and glycoprotein IIb/IIIa inhibitors, as well the impact of the new drugs prasugrel and ticagrelor and the available data concerning cangrelor, elinogrel and PAR-1 inhibitors (still under development).
  
  
  CONCLUSIONS
  This review considers the management of antiplatelet therapy in the light of recent advances, highlighting how to identify patients who will receive the greatest benefit from the older and newer agents, and underscoring the importance of carefully balancing the risks of ischaemia and bleeding in order to improve clinical outcomes. Finally, the paper discusses the potential role of functional and genetic tests in guiding the choice of antiplatelet therapy in a future perspective of 'personalised medicine'.
authors.affiliation: Azienda Ospedaliero-Universitaria di Parma, Unità Operativa di Cardiologia, via Gramsci 14, 43126 Parma, Italy. almenozzi@ao.pr.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.forename: Daniela
authors.initials: D
authors.lastname: Lina
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.forename: Francesco
authors.initials: F
authors.lastname: Mantovani
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use; D006801:Humans; D039661:Integrin beta3 / Q000378:metabolism; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D040201:Platelet Membrane Glycoprotein IIb / Q000378:metabolism; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use
chemical_list: D039661:Integrin beta3; D010975:Platelet Aggregation Inhibitors; D040201:Platelet Membrane Glycoprotein IIb; D058921:Purinergic P2Y Receptor Antagonists; D001241:Aspirin