TY - JOUR
T1 - The rationale for and comparisons of different antiplatelet treatments in acute coronary syndrome
AU - Gurbel, Paul A.
AU - Tantry, Udaya S.
PY - 2008/12/1
Y1 - 2008/12/1
N2 - Fundamentally, acute coronary syndromes are platelet-centric diseases, resulting from platelet-rich thrombi that develop at the site of vessel wall injury. In addition to aggregation, platelets modulate a plethora of other important pathophysiologic processes, including inflammation and coagulation. Therefore, a primary goal of therapy in the acute setting should be treatment with agents that provide predictable and superior platelet inhibition to prevent further ischemic events that develop from unchecked high platelet reactivity. Translational research studies of patients undergoing percutaneous revascularization have clearly demonstrated that adverse thrombotic outcomes are associated with high platelet reactivity and the latter is now emerging as a potent measurable cardiovascular risk factor. The intensity of antithrombotic therapy is influenced by patient risk. In the highest risk patients with elevated cardiac biomarkers indicative of myonecrosis, current guidelines support the use of early therapy with glycoprotein IIb/IIIa inhibition, aspirin, and clopidogrel.
AB - Fundamentally, acute coronary syndromes are platelet-centric diseases, resulting from platelet-rich thrombi that develop at the site of vessel wall injury. In addition to aggregation, platelets modulate a plethora of other important pathophysiologic processes, including inflammation and coagulation. Therefore, a primary goal of therapy in the acute setting should be treatment with agents that provide predictable and superior platelet inhibition to prevent further ischemic events that develop from unchecked high platelet reactivity. Translational research studies of patients undergoing percutaneous revascularization have clearly demonstrated that adverse thrombotic outcomes are associated with high platelet reactivity and the latter is now emerging as a potent measurable cardiovascular risk factor. The intensity of antithrombotic therapy is influenced by patient risk. In the highest risk patients with elevated cardiac biomarkers indicative of myonecrosis, current guidelines support the use of early therapy with glycoprotein IIb/IIIa inhibition, aspirin, and clopidogrel.
UR - http://www.scopus.com/inward/record.url?scp=56849102688&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=56849102688&partnerID=8YFLogxK
U2 - 10.1111/j.1540-8183.2008.00408.x
DO - 10.1111/j.1540-8183.2008.00408.x
M3 - Article
C2 - 19090932
AN - SCOPUS:56849102688
VL - 21
SP - S10-S17
JO - Journal of Interventional Cardiology
JF - Journal of Interventional Cardiology
SN - 0896-4327
IS - SUPPL. 1
ER -