Browsing Cork University Hospital by Authors
Modern antiplatelet agents in coronary artery disease.Power, Rachel F; Hynes, Brian G; Moran, Darragh; Yagoub, Hatim; Kiernan, Gary; Ruggiero, Nicholas J; Kiernan, Thomas J; Department of Interventional Cardiology, Cork University Hospital, University College Cork School of Medicine, Cork, Ireland. (2012-10)Dual antiplatelet therapy is well recognized in the prevention of thrombotic complications of acute coronary syndrome and percutaneous coronary interventions. Despite clinical benefits of aspirin and clopidogrel therapy, a number of limitations curtail their efficacy: slow onset of action, variability in platelet inhibitory response and potential drug-drug interactions. Furthermore, the single platelet-activation pathway targeted by these agents allows continued platelet activation via other pathways, ensuring incomplete protection against ischemic events, thus, underscoring the need for alternate antiplatelet treatment strategies. A number of novel antiplatelet agents are currently in advance development and many have established superior effects on platelet inhibition, clinical outcomes and safety profile than clopidogrel in high-risk patients. The aim of this review is to provide an overview of the current status of P2Y12 receptor inhibition and PAR-1 antagonists in determining a future strategy for individualized antiplatelet therapy.