Recent progress on antiplatelet therapy

Abstract

The main pathogenesis of myocardial infarction and ischemic stroke is the arterial thrombosis which develops on the surface of a ruptured atheromatous plaque or damaged endothelium. Platelets are major cellular components of arterial thrombosis, Several antiplatelet drugs. which interfere with certain steps in the activation process. are prescribed for the secondary or primary prevention of cardiovascular events. Recent clinical trials indicate that the benefits of aspirin treatment in the primary prevention vary by sex. Aspirin therapy reduced the risk of ischemic stroke in women and myocardial infarction in men Because even the low-dose aspirin has a potential of bleeding complications. benefits and risks of aspirin treatment should be balanced in the primary prevention. Clopidogrel，an ADP receptor antagonist, is a more potent, but more expensive antiplatelet agent than aspirin. Combined aspirin and clopidogrel treatment is indicated in patients with acute coronary syndrome or coronary stents, but not with stable cardiovascular diseases because of more bleeding complications platelet glycogen llb/llla antagonists block the final common pathway of the platelets aggregation. These drugs are definitely indicated only in high-risk patients with unstable angina / non-ST elevation myocardial infarction or ST elevation .myocardial infarction undergoing primary percutaneous coronary intervention. Dipyridamole has an antiplatelet effect by inhibiting the uptake of adenosine into RBC or endothelial cells, and inhibiting cAMP-specific phosphodiesterase. Combined aspirin and extended-release dipyridamole treatment is indicated in the secondary prevention of ischemic stroke