Platelet inhibition beyond conventional antiplatelet agents: Expanding role of angiotensin receptor blockers, statins and selective serotonin reuptake inhibitors

A. I. Malinin, S. Ong, L. M. Makarov, E. Y. Petukhova, V. L. Serebruany

Research output: Contribution to journalArticle

Abstract

Aspirin, dipyridamole, cilostazol, thienopyridines and glycoprotein IIb/ IIIa inhibitors represent the classical examples of the established antiplatelet agents commonly used for the secondary prevention in patients after vascular events. Obviously, the era of expanding antiplatelet regimens and indications may require new agents as the substitutes, or additions to the available strategies. However, recent results of the majority of antiplatelet trials strongly suggest boarder line advantages in clinical outcomes, and higher associated bleeding risks with the novel antiplatelet agents or/and regimens. Moreover, unexpected failures, such as lack of efficacy of clopidogrel and aspirin combination for ischaemic stroke prevention (MATCH), or use of the same antiplatelet regimen for the primary vascular prevention (CHARISMA) raise legitimate concerns that the concept 'the more the better' may not be valid. Broad use of statins, angiotensin receptor blockers and selective serotonin reuptake inhibitors may be in part responsible for the lack of impressive results with the antiplatelet therapy because each of these drug classes per se inhibits platelets. In this review, we discuss the available evidence and potential clinical significance of these findings.

Original languageEnglish (US)
Pages (from-to)993-1002
Number of pages10
JournalInternational Journal of Clinical Practice
Volume60
Issue number8
DOIs
StatePublished - Aug 2006
Externally publishedYes

Keywords

  • Angiotensin receptor blockers
  • Antiplatelet agents
  • Clinical trials
  • Platelets
  • Selective serotonin reuptake inhibitors
  • Statins

ASJC Scopus subject areas

  • Medicine(all)

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