New Frontiers in the Management of Acute Coronary Syndromes: Cangrelor and Elinogrel
Ivano Bonadei, Edoardo Sciatti, Enrico Vizzardi, Antonio D’Aloia, Riccardo Raddino and Marco Metra
Affiliation: New reversible inhibitors of platelets P2Y12 receptor, Piazzale Spedali civili, 1, 25100 Brescia, Italy.
Keywords: Acute coronary syndrome, cangrelor, elinogrel, percutaneous coronary intervention, myocardial infarction.
The activation and aggregation of platelets at sites of vascular injury or near to implanted stent are pivotal in
the development of thrombotic events during and after an acute coronary syndrome (ACS) or a percutaneous coronary intervention
(PCI). For that reason, an exclusively oral dual antiplatelet treatment regimen with platelet P2Y12 receptor antagonists
in addition to the cyclooxygenase inhibitor aspirin has become the cornerstone of treatment in that contest.
However, every trial underlines the same problem: if maximizing antiplatelet therapy significantly attenuates ischemic
events in patients with coronary artery disease, on the other side it may also increase bleeding phenomena. These limitations
have prompted a search for novel antiplatelet agents with a more favorable risk–benefit ratio. Moreover, an early onset
of action is desirable during PCI and an early offset after bleeding events. Two novel antiplatelet agents, Cangrelor and
Elinogrel, are available in intravenous form (Elinogrel also in oral form) and expand this context. Recent trials have tested
them against Clopidogrel regarding efficacy and safety outcomes.This review aimed at providing an overview on intravenous
emerging compounds and recent patents in the setting of ACS and PCI.
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