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Novel Antiplatelet Agents in Cardiovascular Medicine

  • Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker, particularly clopidogrel, has been the standard of therapy for secondary prevention in patients with acute coronary syndromes and patients treated with percutaneous coronary intervention. More potent P2Y12 inhibitors such as ticagrelor and prasugrel are associated with better pharmacodynamic effect and improved clinical outcomes but are associated with an increased risk of bleeding compared to clopidogrel. In addition, the observation of treatment failure in ~10 % of high-risk patients treated with aspirin and a potent P2Y12 inhibitor is another major concern. Personalized antiplatelet therapy based on therapeutic winnow concept for P2Y12 receptor blocker may facilitate the balance between reducing ischemic events and avoiding bleeding events, thereby improving net clinical outcome. New class of agents like vorapaxar has been approved by the FDA to reduce thrombotic events in patients with a history of myocardial infarction or with peripheral arterial disease. In addition, new P2Y12 receptor and protease-activated receptor (PAR)-1 receptor antagonists and agents targeting intracellular signaling downstream from G protein-coupled receptors are among the novel strategies under investigation to prevent arterial ischemic event occurrences.

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Conflict of Interest

Rahil Rafeedheen, Kevin P. Bliden, Fang Liu, and Udaya S. Tantry, each declare no potential conflicts of interest.

Dr Gurbel reports serving as a consultant/receiving honoraria from Daiichi Sankyo, Bayer, AstraZeneca, Merck, and Janssen; receiving grants from the National Institutes of Health, Daiichi Sankyo, CSL, AstraZeneca, Harvard Clinical Research Institute, Bayer, Haemonetics, Duke Clinical Research Institute, Sinnowa, Coramed and Accriva.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, 2401 W. Belvedere Ave., Baltimore, MD, 21215, USA

    Rahil Rafeedheen MD, Kevin P. Bliden MBA, Fang Liu MD, Udaya S. Tantry PhD & Paul A. Gurbel MD

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  1. Rahil Rafeedheen MD
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  2. Kevin P. Bliden MBA
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  3. Fang Liu MD
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  4. Udaya S. Tantry PhD
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  5. Paul A. Gurbel MD
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Correspondence to Paul A. Gurbel MD.

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This article is part of the Topical Collection on Coronary Artery Disease

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Rafeedheen, R., Bliden, K.P., Liu, F. et al. Novel Antiplatelet Agents in Cardiovascular Medicine. Curr Treat Options Cardio Med 17, 23 (2015). https://doi.org/10.1007/s11936-015-0383-0

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