Abstract
In recent years, much progress has been made in the field of antithrombotic drugs in acute coronary syndrome (ACS) treatment, as reflected by the introduction of the more potent P2Y12-inhibitors prasugrel and ticagrelor, and novel forms of concomitant anticoagulation, such as fondaparinux and bivalirudin. However, despite substantial improvements in contemporary ACS treatment, there remains residual ischemic risk in this group and hence the need for even more effective antithrombotic drugs, while balancing antithrombotic efficacy against bleeding risk. This review discusses recently introduced and currently developed antiplatelet and anticoagulant drugs in ACS treatment.
Highlights
Aspirin is the cornerstone of the antithrombotic management of coronary artery disease and other atherothrombotic diseases
Patients treated with potent are currently being developed, which include several novel potent antiplatelet drugs targeting antithrombotic drugs are exposed to a substantial bleeding risk
There is a glance of several promising new antithrombotic drugs on the horizon
Summary
Aspirin is the cornerstone of the antithrombotic management of coronary artery disease and other atherothrombotic diseases. Despite developments in the treatment of ACS, such as improvements in percutaneous coronary interventions (PCI), recurrent ischemic events were frequent. This prompted the development of more potent platelet inhibitors. Patients treated with potent are currently being developed, which include several novel potent antiplatelet drugs targeting antithrombotic drugs are exposed to a substantial bleeding risk. The development of FIX, FXI, and FXII inhibitors seems develop effective antithrombotic drugs with minimal hemorrhagic complications. This review discusses promising, with the potential of reducing thrombus formation with only minimal effect on bleeding. Recently introduced and currently developed antiplatelet and anticoagulant drugs in ACS. (serotonin); AA, arachidonic acid; ADP, adenosine diphosphate; ATIII, antithrombin III; ATP, adenosine triphosphate; Ca2+ , calcium; COX1, cyclo-oxygenase 1; GP, glycoprotein; IXa, activated factor IX; P2 × 1, platelet ATP receptor; LMWH, low- molecular weight heparin; P2Y1 /P2Y12 , platelet ADP receptors; PAR, protease activated receptor; PLA2, phospholipase A2; PSGL1, P-selectin glycoprotein ligand 1; TF, tissue factor; TPα, thromboxane receptor α; TXA2, thromboxane A2; TXA2s, thromboxane A2 synthase; Va, activated factor V; VIIa, activated factor VII; VIIIa, activated factor VIII; VASP, vasodilator-stimulated phosphoprotein; vWF, von Willebrand factor; Xa, activated factor X; XIa, activated factor XI; XIIa, activated factor XII; XIIIa, activated factor XII
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