Antiplatelet therapy in acute coronary syndromes
1 Institut fuer Herzinfarktforschung Ludwigshafen an der Universitaet Heidelberg, Bremser Str. 79, 67063 Ludwigshafen, Germany
2 Universitat de Barcelona, Villarroel, 170, Barcelona 8036, Spain
* Corresponding author. Tel: +49 621 503 4000; fax: +49 621 503 4044. E-mail address: gitta{at}klilu.de
Antiplatelet agents are an essential component of the treatment of acute coronary syndromes (ACS). In numerous clinical trials, aspirin, thienopyridines, and glycoprotein IIb/IIIa inhibitors have been shown to reduce the incidence of ischaemic events in patients with unstable angina, non-ST-elevation myocardial infarction, and ST-elevation myocardial infarction. Aspirin is appropriate for lifelong therapy in patients with ACS. Clopidogrel is recommended for most patients with ACS for short- or long-term therapy, depending on the patient’s level of risk. New antiplatelet agents with distinct pharmacological properties may offer advantages, including faster onset of action, greater potency, and reversibility of effects. The treatment of ACS has evolved considerably in the past decade, with a trend towards greater consistency of care and more widespread provision of evidence-based therapies. Registries and surveys offer opportunities to educate health care providers on compliance with current guideline recommendations for the management of patients with ACS, which should lead to improved clinical outcomes.
Key Words: Aspirin • Clopidogrel • Myocardial infarction • Percutaneous coronary intervention • Stroke • Drug-eluting stent