Aspirin and clopidogrel in acute coronary syndromes: therapeutic insights from the CURE study

Archives of Internal Medicine
Hani JneidGary S Francis

Abstract

Platelet adhesion, activation, and aggregation are central to thrombus formation, which follows atherosclerotic plaque disruption and causes acute coronary syndromes. Aspirin and clopidogrel exert their antiplatelet effects by inhibiting thromboxane A2 production and adenosine diphosphate-induced platelet aggregation pathways, respectively. Aspirin has proven benefits in primary and secondary prevention of coronary artery disease. Clopidogrel, an alternative antiplatelet agent used in patients with aspirin intolerance, is especially useful in combination with aspirin after coronary stent procedures. The CURE (Clopidogrel in Unstable Angina to Prevent Recurrent Events) study demonstrates for the first time the benefit of adding clopidogrel to aspirin rather than using aspirin alone in patients having acute coronary syndromes without ST-segment elevation myocardial infarction. Patients who are resistant to aspirin (up to 10%) have higher rates of cardiovascular events and may derive special benefit from the combination therapy. Aspirin resistance can be assessed through platelet aggregometry testing, measurement of urinary thromboxane metabolites, and, possibly, genomic testing in the future.

Citations

Jul 31, 2013·Cardiovascular and Interventional Radiology·Stavros SpiliopoulosMiltiadis Krokidis
Aug 6, 2014·Cardiology Clinics·Sukhdeep S BasraHani Jneid
Apr 7, 2004·Current Treatment Options in Cardiovascular Medicine·Geoffrey C. Cloud, Hugh S. Markus
Dec 10, 2003·Expert Opinion on Emerging Drugs·Hani Jneid, Deepak L Bhatt
May 27, 2006·Journal of Interventional Cardiology·Jennifer White
Mar 12, 2004·Expert Opinion on Pharmacotherapy·Wai Khoon HoJohn W Eikelboom
Sep 20, 2005·Journal of the American College of Cardiology·Peter J MasonJane E Freedman
May 4, 2016·Current Atherosclerosis Reports·Michael GilletteHani Jneid
Jan 16, 2007·Arquivos brasileiros de endocrinologia e metabologia·Cristiane B LeitãoLuis H Canani
Oct 10, 2006·Journal of Thrombosis and Haemostasis : JTH·P Harrison, D Keeling
Feb 19, 2009·International Journal of Clinical Practice·L BjörklundE Lesén
Jun 21, 2011·Journal of Cataract and Refractive Surgery·Irina S BarequetOphira Salomon
Aug 30, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Marc-André d'EntremontMichel Nguyen
Jul 18, 2016·Current Cardiology Reports·Abigail JohnstonAdrian F Hernandez
Nov 14, 2019·International Journal of Molecular Sciences·Simeng LiJustin R Hamilton
May 20, 2019·Current Cardiology Reports·Aaron Shanker, Vivek Bhupathi
Mar 15, 2008·Critical Pathways in Cardiology·Sameer Rohatgi, Herbert D Aronow
Mar 13, 2021·The American Journal of Cardiology·Deepak L Bhatt, Charles V Pollack
Aug 29, 2021·Pharmaceutics·Nolwenn TessierCatherine Martel
Feb 8, 2008·American Journal of Ophthalmology·Simon K LawJoseph Caprioli
Feb 1, 2011·Pharmacology & Therapeutics·Young-Jung LeeJin Tae Hong

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Coagulation Signaling Pathways

Coagulation is the process by which a blood clot is formed. This process includes both the formation of a platelet plug as well as a cascade of clotting factors resulting in the formation of fibrin strands. Find the latest research on coagulation signaling pathways here.

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.