Title:Antiplatelet Therapy in Acute Coronary Syndromes. Evidence Based Medicine
Volume: 22
Issue: 29
Author(s): Evangelos Oikonomou, Georgia Vogiatzi, Georgios-Angelos Papamikroulis, Leon Naar, Gerasimos Siasos, Konstantinos Mourouzis, Theodoros Zografos, Manolis Vavuranakis, Alexis Antonopoulos and Dimitris Tousoulis
Affiliation:
Keywords:
Acute coronary syndrome, anti-platelets, aspirin, ADP receptor, dual antiplatelet treatment, triple oral antithrombotic treatment.
Abstract: Background: Acute coronary syndromes (ACS) represent the final step in the
chronic process of atherothrombotic coronary disease which begins early in life as thickening
of intima layer and progresses to fibroatheroma and fibrocalcific lesions with vulnerable
characteristics. Methods: As abrupt occlusion in the settings of ACS happens due to platelet
aggregation and mobilization antiplatelet treatment has gained significant interest especially
in the settings of primary percutaneous intervention and the aim of this review article is to
understand the current evidence justifying the use and combination of different antiplatelet
agents. Results: Beyond aspirin, several antiplatelet agents (ADP receptor inhibitors, Glycoprotein
IIb/IIIa inhibitors and varopaxar) are used in combination to effectively inhibit
platelet activity. However the best choice, initiation, combination and duration of antithrombotic
treatment, in order to maximize the effectiveness of therapy and reduce the hazard
of bleeding, depends on the clinical setting and patient specific characteristics and is an
issue of intense scientific interest. Conclusion: Early and potent platelet inhibition with safety reassurance can
be achieved by a combination of antiplatelet agents and is essential for the management of ACS. Therefore in
this review article we focus on the current evidence regarding rational, safety and effectiveness of current antiplatelet
approaches in acute coronary syndromes.
