Title

Antiplatelet strategies: evaluating their current role in the setting of acute coronary syndromes

UMMS Affiliation

Department of Pediatrics

Date

3-2008

Document Type

Article

Medical Subject Headings

Acute Coronary Syndrome; Angioplasty, Balloon, Coronary; Antibodies, Monoclonal; Aspirin; Blood Platelets; Drug Administration Schedule; Drug Resistance; Drug Therapy, Combination; Humans; Immunoglobulin Fab Fragments; Myocardial Infarction; Patient Selection; Platelet Aggregation Inhibitors; Platelet Function Tests; Platelet Glycoprotein GPIIb-IIIa Complex; Risk Assessment; Thrombosis; Ticlopidine; Time Factors; Treatment Outcome

Disciplines

Hematology | Oncology | Pediatrics

Abstract

Numerous clinical trials have established the value of antiplatelet therapies for acute coronary syndromes (ACS). Aspirin (ASA), thienopyridines (i.e., clopidogrel and ticlopidine) and GP IIb/IIIa antagonists comprise the major classes of antiplatelet therapies demonstrated to be of benefit in the treatment of ACS and for the prevention of thrombotic complications of percutaneous coronary intervention (PCI). Clopidogrel is beneficial when administered before and after PCI, and is more effective when combined with either ASA or GP IIb/IIIa inhibitors in preventing post-PCI complications, coronary subacute stent thrombosis, and thrombotic events in general. It is currently unclear whether a higher loading dose of clopidogrel (600 mg) is better than the standard loading dose (300 mg), how long therapy should continue, and which maintenance dose is optimal. The role of the GP IIb/IIIa antagonists in ACS is less clear due to conflicting data from several studies with different patient populations. Currently, it appears that the use of GP IIb/IIIa antagonists might be most beneficial in high-risk ACS patients scheduled to undergo PCI, who demonstrate non-ST-segment elevation myocardial infarction and elevated troponin levels.

Rights and Permissions

Citation: Clin Cardiol. 2008 Mar;31(3 Suppl 1):I2-9. doi 10.1002/clc.20362

Related Resources

Link to article in PubMed

PubMed ID

18481818