title: Modern antiplatelet agents in coronary artery disease.
abstract: Dual antiplatelet therapy is well recognized in the prevention of thrombotic complications of acute coronary syndrome and percutaneous coronary interventions. Despite clinical benefits of aspirin and clopidogrel therapy, a number of limitations curtail their efficacy: slow onset of action, variability in platelet inhibitory response and potential drug-drug interactions. Furthermore, the single platelet-activation pathway targeted by these agents allows continued platelet activation via other pathways, ensuring incomplete protection against ischemic events, thus, underscoring the need for alternate antiplatelet treatment strategies. A number of novel antiplatelet agents are currently in advance development and many have established superior effects on platelet inhibition, clinical outcomes and safety profile than clopidogrel in high-risk patients. The aim of this review is to provide an overview of the current status of P2Y12 receptor inhibition and PAR-1 antagonists in determining a future strategy for individualized antiplatelet therapy.
authors.affiliation: Department of Interventional Cardiology, Cork University Hospital, University College Cork School of Medicine, Cork, Ireland.
authors.forename: Rachel F
authors.initials: RF
authors.lastname: Power
authors.forename: Brian G
authors.initials: BG
authors.lastname: Hynes
authors.forename: Darragh
authors.initials: D
authors.lastname: Moran
authors.forename: Hatim
authors.initials: H
authors.lastname: Yagoub
authors.forename: Gary
authors.initials: G
authors.lastname: Kiernan
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Ruggiero
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Kiernan
mesh_terms: D000818:Animals; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000503:physiopathology; D015195:Drug Design; D004359:Drug Therapy, Combination; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D057285:Precision Medicine; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D058925:Receptors, Purinergic P2Y12 / Q000187:drug effects
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D058925:Receptors, Purinergic P2Y12