The rationale for and comparisons of different antiplatelet treatments in acute coronary syndrome.


Journal Article (Review)

Fundamentally, acute coronary syndromes are platelet-centric diseases, resulting from platelet-rich thrombi that develop at the site of vessel wall injury. In addition to aggregation, platelets modulate a plethora of other important pathophysiologic processes, including inflammation and coagulation. Therefore, a primary goal of therapy in the acute setting should be treatment with agents that provide predictable and superior platelet inhibition to prevent further ischemic events that develop from unchecked high platelet reactivity. Translational research studies of patients undergoing percutaneous revascularization have clearly demonstrated that adverse thrombotic outcomes are associated with high platelet reactivity and the latter is now emerging as a potent measurable cardiovascular risk factor. The intensity of antithrombotic therapy is influenced by patient risk. In the highest risk patients with elevated cardiac biomarkers indicative of myonecrosis, current guidelines support the use of early therapy with glycoprotein IIb/IIIa inhibition, aspirin, and clopidogrel.

Full Text

Duke Authors

Cited Authors

  • Gurbel, PA; Tantry, US

Published Date

  • December 2008

Published In

Volume / Issue

  • 21 Suppl 1 /

Start / End Page

  • S10 - S17

PubMed ID

  • 19090932

Pubmed Central ID

  • 19090932

Electronic International Standard Serial Number (EISSN)

  • 1540-8183

Digital Object Identifier (DOI)

  • 10.1111/j.1540-8183.2008.00408.x


  • eng

Conference Location

  • United States