title: New frontiers in the management of acute coronary syndromes: cangrelor and elinogrel.
abstract: The activation and aggregation of platelets at sites of vascular injury or near to implanted stent are pivotal in the development of thrombotic events during and after an acute coronary syndrome (ACS) or a percutaneous coronary intervention (PCI). For that reason, an exclusively oral dual antiplatelet treatment regimen with platelet P2Y12 receptor antagonists in addition to the cyclooxygenase inhibitor aspirin has become the cornerstone of treatment in that contest. However, every trial underlines the same problem: if maximizing antiplatelet therapy significantly attenuates ischemic events in patients with coronary artery disease, on the other side it may also increase bleeding phenomena. These limitations have prompted a search for novel antiplatelet agents with a more favorable risk-benefit ratio. Moreover, an early onset of action is desirable during PCI and an early offset after bleeding events. Two novel antiplatelet agents, Cangrelor and Elinogrel, are available in intravenous form (Elinogrel also in oral form) and expand this context. Recent trials have tested them against Clopidogrel regarding efficacy and safety outcomes.This review aimed at providing an overview on intravenous emerging compounds and recent patents in the setting of ACS and PCI.
authors.forename: Ivano
authors.initials: I
authors.lastname: Bonadei
authors.forename: Edoardo
authors.initials: E
authors.lastname: Sciatti
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.forename: Riccardo
authors.initials: R
authors.lastname: Raddino
authors.affiliation: New reversible inhibitors of platelets P2Y12 receptor, Piazzale Spedali civili, 1, 25100 Brescia, Italy. ivano.bonadei@libero.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D000249:Adenosine Monophosphate / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D010330:Patents as Topic; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D058921:Purinergic P2Y Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D052999:Quinazolinones / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D013449:Sulfonamides / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D052999:Quinazolinones; D013449:Sulfonamides; D000249:Adenosine Monophosphate; C117446:cangrelor; C549473:elinogrel