title: Why we need intravenous antiplatelet agents.
abstract: Oral ADP-receptor antagonists combined with aspirin are the standard for dual antiplatelet therapy (DAPT) during percutaneous coronary intervention (PCI). However, the oral route of administration of ADP-receptor antagonists leaves them vulnerable to unpredictable and often inadequate platelet inhibition at the time of PCI, while their prolonged effects often lead to the decision not to load them prior to PCI. Intravenous antiplatelet agents, including glycoprotein IIb/IIIa inhibitors (GPI) and cangrelor, a reversible P2Y12 inhibitor, address these shortcomings. In June 2015, the US FDA approved cangrelor for the prevention of thrombotic events associated with coronary stenting. This review examines the current state of peri-PCI DAPT and demonstrates that the selective use of GPIs and intravenous ADP-antagonist agents reduces the risk of periprocedural thrombosis.
authors.affiliation: Department of Cardiology, Long Beach Veteran's Affairs Medical Center, 5901 East 7th Street, Long Beach, CA 90822, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Tyler
authors.affiliation: Department of Cardiology, Long Beach Veteran's Affairs Medical Center, 5901 East 7th Street, Long Beach, CA 90822, USA.
authors.forename: Ryan Jw
authors.initials: RJ
authors.lastname: Burris
authors.affiliation: Department of Cardiology, Long Beach Veteran's Affairs Medical Center, 5901 East 7th Street, Long Beach, CA 90822, USA.
authors.forename: Arnold H
authors.initials: AH
authors.lastname: Seto
mesh_terms: D000249:Adenosine Monophosphate / Q000008:administration & dosage / Q000031:analogs & derivatives*; D001241:Aspirin / Q000008:administration & dosage; D001792:Blood Platelets / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage*
chemical_list: D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D058921:Purinergic P2Y Receptor Antagonists; D000249:Adenosine Monophosphate; C117446:cangrelor; D001241:Aspirin
keywords: cangrelor; clopidogrel; glycoprotein IIb/IIIa inhibitors; intravenous antiplatelet agents; prasugrel; ticagrelor