THIENOPYRIDINES: PLATELET ADP RECEPTOR ANTAGONIST

Abstract

Atherothrombotic disease is the result of atherosclerosis progression, and its clinical manifestations [acute coronary syndromes (ACS), stroke, etc). These events are mostly secondary to atherosclerotic plaque disruption and subsequent thrombus formation. Atherosclerosis prevention is mainly focused on the management of the so-called ‘cardiovascular risk factors’; whereas thrombosis-related complications are mainly prevented and/or treated by antithrombotic therapies. The central role of platelets in the pathophysiology of arterial vascular disease has focused attention on the development of effective platelet inhibitor modalities to mitigate the clinical consequences of atherothrombotic disease. Aspirin has been the mainstay; the thienopyridines provide new opportunities for those patients who are intolerant, resistant or have failed aspirin, and for those who can derive greater benefit from combined therapy. Thienopyridines (ticlopidine, clopidogrel etc.) are a class of ADP receptor/P2Y12 inhibitors used for their anti-platelet activity. The co-administration aspirin-clopidogrel results in enhancement of platelet inhibition, since they act via different platelet receptors. This article reviews the current antiplatelet agents in ACSs and role of thienopyridines as antiplatelet agents in management.