Improving long-term ACS management: is there a role for the new antiplatelets?

Journal of Interventional Cardiology
Marc Cohen

Abstract

Acute coronary syndrome (ACS) is a major health burden, resulting in increased hospital admissions and significant morbidity and mortality. Platelet activation, which leads to thrombin generation, is highly implicated in ACS, and antiplatelet agents represent the current standard of care. Established antiplatelet agents include acetylsalicylic acid (ASA), thienopyridines (clopidogrel, ticlopidine), and glycoprotein IIb/IIIa inhibitors. Recently, antiplatelet therapy for ACS has evolved to include more potent inhibitors (e.g., prasugrel, cangrelor, and ticagrelor). During the acute phase of an acute coronary event, both anticoagulation and dual antiplatelet therapy with aspirin and a thienopyridine are guideline recommended as first-line treatment. While anticoagulation is usually limited to the acute in-patient phase, dual antiplatelet therapy is recommended for 12 months. Despite the efficacy of antiplatelet agents in ACS, in many patients the residual risk of death from cardiac events, myocardial infarction, stroke, and refractory ischemia remains high. Dual therapy (i.e., ASA or clopidogrel plus a vitamin K antagonist [VKA]), and triple therapy (two antiplatelets plus a VKA) are associated with increases in bleeding complica...Continue Reading

References

Jul 16, 1992·The New England Journal of Medicine·P ThérouxJ McCans
Aug 25, 2001·Lancet·S R MehtaUNKNOWN Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators
Feb 28, 2002·Circulation·Jeffrey I Weitz, Harry R Buller
Jun 7, 2003·BMJ : British Medical Journal·Ever D Grech, David R Ramsdale
Jun 29, 2005·Circulation·Peter Libby, Pierre Theroux
Mar 16, 2006·JAMA : the Journal of the American Medical Association·Salim YusufUNKNOWN OASIS-6 Trial Group
Aug 1, 2007·Journal of Thrombosis and Haemostasis : JTH·J I Weitz
Nov 6, 2007·The New England Journal of Medicine·Stephen D WiviottUNKNOWN TRITON-TIMI 38 Investigators
Dec 22, 2007·European Heart Journal·Alexander G G Turpie
Aug 30, 2008·The New England Journal of Medicine·Bruce Furie, Barbara C Furie
Jul 4, 2009·Journal of the American College of Cardiology·David R HolmesCindy L Grines
Sep 1, 2009·The New England Journal of Medicine·Lars WallentinMona Thorsén
Nov 17, 2009·The New England Journal of Medicine·Robert A HarringtonDeepak L Bhatt
Nov 17, 2009·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHAMPION PLATFORM Investigators
Aug 31, 2010·Current Opinion in Critical Care·Zafar Iqbal, Marc Cohen
Dec 17, 2010·Circulation·Véronique L RogerUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
May 11, 2011·Expert Opinion on Investigational Drugs·Deepu Alexander, Allen Jeremias
Nov 15, 2011·The New England Journal of Medicine·Pierluigi TricociUNKNOWN TRACER Investigators

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Citations

Mar 28, 2013·Cardiology Research and Practice·Adriana Dana Oprea, Wanda M Popescu

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