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Oral antiplatelets in primary and secondary prevention of myocardial infarction: a review

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Abstract

There are a number of guidelines and articles available for the use of oral antiplatelets for primary and secondary prevention of myocardial infarction (MI). Antiplatelet medications inhibit platelet activation, aggregation, and other pathways eventually inhibiting clot formation. Aspirin and clopidogrel have been the mainstay in the management of acute coronary syndrome for about a decade. We have discussed the role of aspirin, clopidogrel, ticagrelor, and prasugrel which are the most commonly used oral antiplatelet medications in the current era. We have also considered the role of newer thrombin inhibitor vorapaxar, and dual antiplatelet therapy. In this review paper, we have summarized the continuing controversy about the use of oral antiplatelet therapy and their role in primary as well as secondary prevention of MI by describing results from major clinical trials. The safety and the efficacy of the above medications have been reviewed and described in this paper.

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Authors and Affiliations

  1. Department of Internal Medicine, Renown Regional Medical Centre, University of Nevada Reno School of Medicine, 1155 Mill St, W-11, Reno, NV, 89502, USA

    Rajkumar Doshi

  2. Department of Cardiology, North Shore University Hospital, Hofstra Northwell School of Medicine, Manhasset, NY, USA

    Abhishek Vadher

  3. Department of Pharmacy, Presbyterian College School of Pharmacy, Clinton, SC, USA

    Priyam Mithawala

  4. Department of Cardiology, Phoebe Putney Memorial Hospital, Albany, GA, USA

    Priyank Shah

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  1. Rajkumar Doshi
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Doshi, R., Vadher, A., Mithawala, P. et al. Oral antiplatelets in primary and secondary prevention of myocardial infarction: a review. Ir J Med Sci 188, 453–467 (2019). https://doi.org/10.1007/s11845-018-1897-8

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