Current and Novel Antiplatelet Therapies for the Treatment of Cardiovascular Diseases

Jourdi, Georges; Lordkipanidzé, Marie; Philippe, Aurélien; Bachelot‐Loza, Christilla; Gaussem, Pascale

doi:10.3390/ijms222313079

Cited by 33 publications

(26 citation statements)

References 177 publications

(173 reference statements)

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“…Development of effective and safe reversal compounds for antiplatelet agents is also an area of unmet need. Moreover, novel antiplatelet drugs are in the pipeline (among which RUC-4, selatogrel, revacept, glenzocimab; non-exhaustive list) (199)(200)(201)(202)(203). How these potential new therapeutics will fit within the current paradigm of antiplatelet therapy and whether they will lead to safer combinations in the clinical practice remain to be determined.…”

Section: Discussionmentioning

confidence: 99%

Antiplatelet Therapy for Atherothrombotic Disease in 2022—From Population to Patient-Centered Approaches

Jourdi

Godiér

Lordkipanidzé

et al. 2022

Front. Cardiovasc. Med.

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Antiplatelet agents, with aspirin and P2Y12 receptor antagonists as major key molecules, are currently the cornerstone of pharmacological treatment of atherothrombotic events including a variety of cardio- and cerebro-vascular as well as peripheral artery diseases. Over the last decades, significant changes have been made to antiplatelet therapeutic and prophylactic strategies. The shift from a population-based approach to patient-centered precision medicine requires greater awareness of individual risks and benefits associated with the different antiplatelet strategies, so that the right patient gets the right therapy at the right time. In this review, we present the currently available antiplatelet agents, outline different management strategies, particularly in case of bleeding or in perioperative setting, and develop the concept of high on-treatment platelet reactivity and the steps toward person-centered precision medicine aiming to optimize patient care.

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Section: Discussionmentioning

confidence: 99%

Antiplatelet Therapy for Atherothrombotic Disease in 2022—From Population to Patient-Centered Approaches

Jourdi

Godiér

Lordkipanidzé

et al. 2022

Front. Cardiovasc. Med.

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“…Differences among individual patients should be considered when weighing the treatment best suited to each individual patient. With the development of novel antiplatelet agents ( Jourdi et al, 2021 ) allegedly associated with lower bleeding risk while exhibiting at least comparable antithrombotic potency compared to the currently available drugs, antiplatelet therapy management in CVD patients is expected to change in the years ahead.…”

Section: Discussionmentioning

confidence: 99%

Antiplatelet Therapy in Atherothrombotic Diseases: Similarities and Differences Across Guidelines

et al. 2022

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Antiplatelet therapy, mainly consisting of aspirin and P2Y12 receptor antagonists, is the cornerstone of the pharmacological treatment and prevention of atherothrombotic diseases. Its use, especially in secondary cardiovascular prevention, has significantly improved patient clinical outcomes in the last decades. Primary safety endpoint (i.e., bleeding complications) remain a major drawback of antiplatelet drugs. National and international societies have published and regularly updated guidelines for antiplatelet therapy aiming to provide clinicians with practical recommendations for a better handling of these drugs in various clinical settings. Many recommendations find common ground between international guidelines, but certain strategies vary across the countries, particularly with regard to the choice of molecules, dosage, and treatment duration. In this review, we detail and discuss the main antiplatelet therapy indications in the light of the different published guidelines and the significant number of recently published clinical trials and meta-analyses and highlight the areas that deserve further investigation in order to improve antiplatelet therapy in patients with atherothrombotic diseases.

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“…The primary mechanism of action of aspirin is centered on the irreversible inhibition of cyclooxygenase (COX 1) enzyme, thus preventing the conversion of arachidonic acid into prostaglandin G2 and prostaglandin H2, subsequently inhibiting thromboxane A2 synthesis. Aspirin acetylates and forms a covalent bond with serine residues in COX active site at position 529, thus inhibiting cox 1 enzyme [15,16]. Other activities of aspirin include mitochondrial oxidative phosphorylation and modulation of NF-KB signals [14].…”

Section: Mechanism Of Action Of Aspirinmentioning

confidence: 99%

“…P2Y12 inhibitors, otherwise known as P2Y12 antagonists, act by blocking P2Y12 adenosine diphosphate (ADP) receptors on platelet surface membrane, subsequently inhibiting thrombocyte activation/aggregation [17]. P2Y12 inhibitors can be classified into two groups: thienopyridines and nucleoside/nucleotide derivatives [16].…”

Section: Mechanism Of Action Of P2y12 Inhibitorsmentioning

confidence: 99%

Dual Antiplatelet Therapy

Orok¹,

Adeniyi²,

Akawa³

2022

Atrial Fibrillation - Diagnosis and Management in the 21st Century

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Antiplatelet agents have been utilized to enhance outcomes in patients with acute coronary syndrome for decades and are increasingly valued for their antithrombotic as well as anti-inflammatory characteristics. Dual antiplatelet therapy (DAPT) is a combination of aspirin and a P2Y12 inhibitor. Different modes of action are employed by these drugs. Aspirin is an anti-inflammatory medication that also has antioxidant characteristics, while P2Y12 inhibitors act by inhibiting thrombocytes activation/aggregation. There are two types of P2Y12 inhibitors: thienopyridines and nucleoside/nucleotide compounds. Nucleoside/nucleotide derivatives are reversible direct-acting P2Y12 receptor antagonists that do not need hepatic metabolism, whereas thienopyridines are competitive and irreversible P2Y12 inhibitors. In patients with acute coronary syndrome or undergoing percutaneous coronary intervention for stable coronary artery disease, dual antiplatelet therapy, which contains aspirin and a P2Y12 receptor inhibitor, has consistently been shown to reduce recurrent major adverse cardiovascular events compared to aspirin monotherapy, but at the cost of an increased risk of major bleeding. This chapter is meant to elaborate on dual antiplatelet therapy highlighting the current guidelines and recent evidences on the indications, dosing, and duration of treatment using dual antiplatelet therapy.

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Current and Novel Antiplatelet Therapies for the Treatment of Cardiovascular Diseases

Cited by 33 publications

References 177 publications

Antiplatelet Therapy for Atherothrombotic Disease in 2022—From Population to Patient-Centered Approaches

Antiplatelet Therapy for Atherothrombotic Disease in 2022—From Population to Patient-Centered Approaches

Antiplatelet Therapy in Atherothrombotic Diseases: Similarities and Differences Across Guidelines

Dual Antiplatelet Therapy

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