Novel platelet-inhibitory drugs, including thienopyridines, cilostazol, and alphaIIbbeta3 antagonists, have demonstrated efficacy in the setting of atherosclerotic cardiovascular disease.
What are the mechanisms and clinical efficacies of novel platelet inhibitors compared to aspirin in patients with atherosclerotic cardiovascular disease?
Novel platelet inhibitors, including ADP receptor antagonists and GPIIb-IIIa inhibitors, offer efficacious alternatives or additions to aspirin for managing atherosclerotic and acute coronary diseases.
Platelet-inhibitory drugs are of proven benefit to individuals who suffer from atherosclerotic cardiovascular disease. Despite substantial effort to identify more potent platelet-inhibitory agents, aspirin, an irreversible inhibitor of platelet cyclooxygenase activity, remains the standard against which other drugs are judged. Drugs that appear to be at least as efficacious as aspirin in specific clinical settings include the thienopyridines ticlopidine and clopidogrel, specific inhibitors of ADP-stimulated platelet function, and the phosphodiesterase 3 inhibitor cilostazol. Ligand binding to the platelet integrin alphaIIbbeta3 (GPIIb-IIIa), a prerequisite for platelet thrombus formation, has been a prominent target for drug development. Currently, three types of alphaIIbbeta3 antagonists are available: the monoclonal antibody Fab fragment abciximab, cyclic peptides based on the Arg-Gly-Asp (RGD) or related amino acid motifs, and RGD-based peptidomimetics. The efficacy of each type of alphaIIbbeta3 antagonist in the setting of acute coronary artery disease has been confirmed in multicenter clinical trials.
Joel Bennett (Thu,) conducted a review in Atherosclerotic cardiovascular disease. Novel platelet-inhibitory drugs (thienopyridines, cilostazol, alphaIIbbeta3 antagonists) vs. Aspirin was evaluated. Novel platelet-inhibitory drugs, including thienopyridines, cilostazol, and alphaIIbbeta3 antagonists, have demonstrated efficacy in the setting of atherosclerotic cardiovascular disease.