Antiplatelet drugs in cardiological practice: established strategies and new developments

Vasc Health Risk Manag. 2008;4(3):637-45. doi: 10.2147/vhrm.s2691.

Abstract

A common pathophysiological course in vascular diseases is an overwhelming activation and aggregation of blood platelets, which results in atherothrombosis. By causing the last decisive step of cerebral, coronary, or peripheral arterial ischemia thrombotic complications of atherosclerotic disease represent a major player in death cause statistics of most western countries. The development of novel therapies against platelet-dependent thrombosis and the concurrent improvement of existing therapeutic strategies thus is a paramount focus of pharmaceutical research. Currently, efficiency, dosing and indications of established antiplatelet substances are being re-evaluated, whilst new, so far unrecognized molecular targets for inhibition of platelet activity come up front. This not only allows for interesting new therapeutical options, but also widens our insight into the role platelets play in atherosclerosis in general. This article summarizes the relevant pathophysiology of platelet activation, presents current concepts in antiplatelet drug therapy, and highlights the role of platelets in vascular diseases apart from atherothrombosis.

Keywords: antiplatelet drug therapy; atherothrombosis; pathophysiology; platelet activation.

Publication types

  • Review

MeSH terms

  • Atherosclerosis / drug therapy*
  • Atherosclerosis / physiopathology
  • Clopidogrel
  • Drug-Eluting Stents
  • Humans
  • Piperazines / administration & dosage
  • Platelet Activation / physiology
  • Platelet Aggregation / physiology
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
  • Prasugrel Hydrochloride
  • Purinergic P2 Receptor Antagonists
  • Pyridines / therapeutic use
  • Receptors, Thromboxane / drug effects
  • Signal Transduction / physiology
  • Thiophenes / administration & dosage
  • Thrombosis / drug therapy*
  • Thrombosis / physiopathology
  • Ticlopidine / administration & dosage
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use

Substances

  • Piperazines
  • Platelet Aggregation Inhibitors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Purinergic P2 Receptor Antagonists
  • Pyridines
  • Receptors, Thromboxane
  • Thiophenes
  • thienopyridine
  • Clopidogrel
  • Prasugrel Hydrochloride
  • Ticlopidine