This review highlights the critical need to individualize antiplatelet therapy in ACS patients to maximize antithrombotic efficacy while minimizing bleeding complications.
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May aid ACS antiplatelet selection balancing thrombosis and bleeding risks; leaves open optimal personalization in future trials.
Platelets play a central role in atherothrombosis and subsequent development of acute coronary syndromes (ACS). The understanding of this process has driven a large body of evidence demonstrating the mortality and morbidity benefits of antiplatelet agents in the ACS population. As expected, however, these agents come with an intrinsically increased risk of bleeding which underlies the vast majority of their complications and adverse effects. In today's setting of compounding comorbidities and broadening indications, finding the balance between thrombosis prevention and bleeding risk remains the challenge for all clinicians considering these medications. This article reviews the current main antiplatelet agents that are available for clinical use and outlines their impact on ACS outcome. We also outline factors which affect the response to these agents and discuss strategies to optimize clinical outcomes.
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M. Worthley (2010) studied this question.
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