Abstract
Platelets play a central role in the pathophysiology of atherothrombosis, an inappropriate platelet activation leading to acute ischemic complications (acute myocardial infarction, ischemic stroke). In view of this, platelets are a major target for pharmacotherapy. Presently, the main classes of antiplatelet agents approved for the use in such complications are aspirin and thienopyridines. Although antiplatelet treatment with these two types of drugs, alone or in combination, leads to a significant reduction of non-fatal myocardial infarction (-32%), non-fatal stroke (-25%), and of cardiovascular death (-17%), a residual risk persists. Newer antiplatelet agents have addressed some, but not all, these limitations. Vis - vis their net clinical benefit, the higher potency of some of them is associated with a rise in bleeding complications. Moreover, newer thienopyridines do not show advantages over and above the older ones as to reduction of stroke. A concerted effort that takes into consideration clinical, genetic, and laboratory information is increasingly recognized as a major direction to be pursued in the area. The well-established road signs of clinical epidemiology will provide major information to define newer potentially useful targets for platelet pharmacology.
| Original language | English |
|---|---|
| Pages (from-to) | 531-544 |
| Number of pages | 14 |
| Journal | Annals of Medicine |
| Volume | 43 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Nov 2011 |
Fingerprint
Keywords
- Aspirin failure
- Cardiovascular prevention
- Clopidogrel failure
- New antiplatelet drugs
ASJC Scopus subject areas
- Medicine(all)
Cite this
Overcoming limitations of current antiplatelet drugs : A concerted effort for more profitable strategies of intervention. / Minno, Matteo Nicola Dario Di; Guida, Anna; Camera, Marina; Colli, Susanna; Minno, Giovanni Di; Tremoli, Elena.
In: Annals of Medicine, Vol. 43, No. 7, 11.2011, p. 531-544.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Overcoming limitations of current antiplatelet drugs
T2 - A concerted effort for more profitable strategies of intervention
AU - Minno, Matteo Nicola Dario Di
AU - Guida, Anna
AU - Camera, Marina
AU - Colli, Susanna
AU - Minno, Giovanni Di
AU - Tremoli, Elena
PY - 2011/11
Y1 - 2011/11
N2 - Platelets play a central role in the pathophysiology of atherothrombosis, an inappropriate platelet activation leading to acute ischemic complications (acute myocardial infarction, ischemic stroke). In view of this, platelets are a major target for pharmacotherapy. Presently, the main classes of antiplatelet agents approved for the use in such complications are aspirin and thienopyridines. Although antiplatelet treatment with these two types of drugs, alone or in combination, leads to a significant reduction of non-fatal myocardial infarction (-32%), non-fatal stroke (-25%), and of cardiovascular death (-17%), a residual risk persists. Newer antiplatelet agents have addressed some, but not all, these limitations. Vis - vis their net clinical benefit, the higher potency of some of them is associated with a rise in bleeding complications. Moreover, newer thienopyridines do not show advantages over and above the older ones as to reduction of stroke. A concerted effort that takes into consideration clinical, genetic, and laboratory information is increasingly recognized as a major direction to be pursued in the area. The well-established road signs of clinical epidemiology will provide major information to define newer potentially useful targets for platelet pharmacology.
AB - Platelets play a central role in the pathophysiology of atherothrombosis, an inappropriate platelet activation leading to acute ischemic complications (acute myocardial infarction, ischemic stroke). In view of this, platelets are a major target for pharmacotherapy. Presently, the main classes of antiplatelet agents approved for the use in such complications are aspirin and thienopyridines. Although antiplatelet treatment with these two types of drugs, alone or in combination, leads to a significant reduction of non-fatal myocardial infarction (-32%), non-fatal stroke (-25%), and of cardiovascular death (-17%), a residual risk persists. Newer antiplatelet agents have addressed some, but not all, these limitations. Vis - vis their net clinical benefit, the higher potency of some of them is associated with a rise in bleeding complications. Moreover, newer thienopyridines do not show advantages over and above the older ones as to reduction of stroke. A concerted effort that takes into consideration clinical, genetic, and laboratory information is increasingly recognized as a major direction to be pursued in the area. The well-established road signs of clinical epidemiology will provide major information to define newer potentially useful targets for platelet pharmacology.
KW - Aspirin failure
KW - Cardiovascular prevention
KW - Clopidogrel failure
KW - New antiplatelet drugs
UR - http://www.scopus.com/inward/record.url?scp=80053091829&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053091829&partnerID=8YFLogxK
U2 - 10.3109/07853890.2011.582137
DO - 10.3109/07853890.2011.582137
M3 - Article
C2 - 21815879
AN - SCOPUS:80053091829
VL - 43
SP - 531
EP - 544
JO - Annals of Medicine
JF - Annals of Medicine
SN - 0785-3890
IS - 7
ER -