Antiplatelet Therapy in the Prevention of Coronary Syndromes: Mode of Action, Benefits, Drawbacks

Susanne      M. Picker

Abstract

Blood platelets play a key role in normal hemostasis but also in atherothrombosis due to their ability of thrombus formation at site of a ruptured atherosclerotic plaque. Platelets are also involved in vascular inflammation due to interactions with endothelial cells, leukocytes, and smooth muscle cells that may result in an excessive fibroproliferative response after vessel dilatation. This review article describes both, the current status of standard anti-platelet drug therapy using acetylsalicylic acid, adenosine diphosphate or glycoprotein IIb-IIIa receptor antagonists in the prevention of cardiovascular events as well as drawbacks like non-responsiveness or increased bleeding rates leading to enhanced reintervention and transfusion rates, both responsible for adverse clinical outcomes after coronary interventions.

Keywords: Abciximab, acetylsalicylic acid, acute coronary syndromes, clopidogrel, fibrinogen receptor antagonists, platelet function, platelet receptor blockade, prasugrel, thienopyridines, thromboxane A2 receptor antagonists, thrombin receptor antagonists, vorapaxar