Antiplatelet therapy in acute coronary syndromes

@article{Grove2015AntiplateletTI,
  title={Antiplatelet therapy in acute coronary syndromes},
  author={Erik Lerkevang Grove and Morten W{\"u}rtz and Mark R Thomas and Steen Dalby Kristensen},
  journal={Expert Opinion on Pharmacotherapy},
  year={2015},
  volume={16},
  pages={2133 - 2147}
}
Introduction: Coronary thrombosis is a frequent cause of death and myocardial infarction most often explained by superimposition of a platelet-rich thrombus on existing coronary artery disease. Therefore, antiplatelet drugs are essential in the treatment and secondary prevention of acute coronary syndromes (ACS) and during percutaneous coronary intervention. Several novel antiplatelet drugs are now available. Areas covered: For several years, aspirin and clopidogrel remained the cornerstone of… 
Combined antiplatelet therapy: still a sweeping combination in cardiology.
TLDR
DAPT combining aspirin with one of the newer more potent agents translates into superior antithrombotic protection in atherothrobotic vascular disease, albeit at an increased, though not inordinately, risk for bleeding complications.
Novel antiplatelet strategies targeting GPVI, CLEC-2 and tyrosine kinases
TLDR
It is suggested that targeting platelet GPVI may provide a novel treatment strategy that provides additional antithrombotic efficacy with minimal disruption of normal hemostasis compared to conventional antiplatelet medications.
The Dipyridamole Added to Dual Antiplatelet Therapy in Cerebral Infarction After First Acute Myocardial Infarction: A Nationwide, Case-Control Study
TLDR
Dipyridamole-DAPT did not improve long-term survival in patients with stroke after AMI, and was related to poor outcomes after 1 year.
Maintained P2Y12 inhibitor monotherapy after shorter‐duration of dual antiplatelet therapy in patients undergoing coronary drug‐eluting stents implantation: An updated meta‐analysis of randomized trials
TLDR
This study is sought to explore the efficacy and safety of a maintained P2Y12 inhibitor monotherapy after shorter‐duration of dual antiplatelet therapy (DAPT) in patients with high in‐stent thrombotic risk.
Benefits and Harm of Treatment with P2Y12 Inhibitors beyond 12 Months in Patients with Coronary Artery Disease.
TLDR
This systematic review and meta-analysis demonstrates a reduction in major cardiovascular events during extended P2Y12-inhibitor treatment beyond 12 months compared with ≤ 12 months in patients with ACS or stable CAD undergoing PCI.
Effects of Cilostazol-Based Triple Antiplatelet Therapy Versus Dual Antiplatelet Therapy After Coronary Drug-Eluting Stent Implantation: An Updated Meta-Analysis of the Randomized Controlled Trials
TLDR
Compared with DAT, cilostazol-based TAT can significantly improve the angiographic findings of in-stent and in-segment late loss, in- Stenosis, TLR, and TVR after DES/second-generation DES implantation, but no benefits were observed in outcomes of all-cause death, cardiac death, ST, and MI.
The Effect of Antiplatelet Medications on Innate Immune Activation
TLDR
Potent inhibition of multiple inflammatory and prothrombotic mechanisms by P2Y12 inhibitors demonstrates critical importance of platelets as central orchestrators of systemic inflammation induced by bacterial endotoxin.
MicroRNA as Biomarkers for Platelet Function and Maturity in Patients with Cardiovascular Disease.
TLDR
A total of 45 miRs were associated with platelet function or maturity in patients with CVD, with miR-223 andMiR-126 being the most frequently investigated, however, the majority of the miR were only investigated in one study.
...
...

References

SHOWING 1-10 OF 119 REFERENCES
Antiplatelet therapy in patients with diabetes mellitus.
TLDR
The rationale for new oral antiplatelet drugs under development is discussed with particular focus on the potential role of these drugs to improve cardiovascular outcomes in patients with DM.
Update on oral antiplatelet therapy: principles, problems and promises.
TLDR
The rationale for important oral antiplatelet drugs in development is highlighted, clinical perspectives on their pharmacological advantages and challenges are provided and possible benefits of upcoming drugs are discussed.
Can we improve the efficacy of low-dose aspirin?
TLDR
The clinical message from the study by Bonten et al. (1) is that taking aspirin at bedtime instead of in the morning may reduce the risk of cardiovascular events in theMorning, based on the presumptions that platelet aggregation is higher in themorning and that the platelet inhibitory effect of aspirin is not sustained during the usual 24-hour dosing interval.
Prasugrel versus clopidogrel in patients with acute coronary syndromes.
TLDR
In patients with acute coronary syndromes with scheduled percutaneous coronary intervention, prasugrel therapy was associated with significantly reduced rates of ischemic events, including stent thrombosis, but with an increased risk of major bleeding, including fatal bleeding.
Interindividual variability in the efficacy of oral antiplatelet drugs: definitions, mechanisms and clinical importance.
TLDR
An integrated review of interindividual variability in the efficacy of aspirin and clopidogrel with particular emphasis on possible effect-modifying mechanisms and clinical implications is provided.
EFFECTS OF CLOPIDOGREL IN ADDITION TO ASPIRIN IN PATIENTS WITH ACUTE CORONARY SYNDROMES WITHOUT ST-SEGMENT ELEVATION
TLDR
The antiplatelet agent clopidogrel has beneficial effects in patients with acute coronary syndromes without ST-segment elevation, however, the risk of major bleeding is increased among patients treated with clopIDogrel.
Effect of platelet inhibition with cangrelor during PCI on ischemic events.
TLDR
Cangrelor significantly reduced the rate of ischemic events, including stent thrombosis, during PCI, with no significant increase in severe bleeding.
Greater Clinical Benefit of More Intensive Oral Antiplatelet Therapy With Prasugrel in Patients With Diabetes Mellitus in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel–Thrombolysis in Myocardial Infarction 38
TLDR
Subjects with DM tended to have a greater reduction in ischemic events without an observed increase in TIMI major bleeding and therefore a greater net treatment benefit with prasugrel compared with clopidogrel, demonstrating that the more intensive oral antiplatelet therapy provided with pr asugrel is of particular benefit to patients with DM.
...
...