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

Published

Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Braunwald, E; Angiolillo, D; Bates, E; Berger, PB; Bhatt, D; Cannon, CP; Furman, MI; Gurbel, P; Michelson, AD; Peterson, E; Wiviott, S

Published Date

  • March 2008

Published In

Volume / Issue

  • 31 / 3 Suppl 1

Start / End Page

  • I2 - I9

PubMed ID

  • 18481818

Pubmed Central ID

  • 18481818

International Standard Serial Number (ISSN)

  • 0160-9289

Digital Object Identifier (DOI)

  • 10.1002/clc.20362

Language

  • eng

Conference Location

  • United States