Efficacy, Safety, and Role of Antiplatelet Drugs in the Management of Acute Coronary Syndrome: A Comprehensive Review of Literature

Abstract

Acute coronary syndrome (ACS) is a complex condition characterized by myocardial ischemia or infarction which can lead to significant morbidity and death. Antiplatelet drugs play a crucial role in the management of ACS and have been shown to minimize the incidence of significant adverse cardiovascular events and recurrent myocardial infarction (MI). This comprehensive literature review is intended to summarize current information on the effectiveness, safety, and function of frequently used antiplatelet medications in treating ACS.Aspirin, clopidogrel, prasugrel, ticagrelor, abciximab, tirofiban, dipyridamole, cilostazol, and novel antiplatelets are included in the review. Aspirin's effectiveness as a first-line antiplatelet medication in ACS is well established. It has significantly lowered the risk of serious adverse cardiovascular events. Clopidogrel, prasugrel, and ticagrelor are P2Y12 receptor inhibitors found to lower the incidence of recurrent ischemia episodes in ACS patients.Using glycoprotein IIb/IIIa inhibitors such as abciximab, tirofiban, and eptifibatide is effective in managing ACS, especially in high-risk patients. Dipyridamole effectively reduces the risk of recurrent ischemic events in patients with ACS, particularly when used with aspirin. Cilostazol, a phosphodiesterase III inhibitor, has also been shown to reduce the risk of major adverse cardiovascular events (MACE) in patients with ACS.Antiplatelet drugs' safety in managing ACS has also been well established. Aspirin is generally well-tolerated with a low risk of adverse effects, although the risk of bleeding events, particularly gastrointestinal bleeding, cannot be eliminated. The P2Y12 receptor inhibitors have been associated with a small increase in the risk of bleeding events, particularly in patients with a high risk of bleeding. The glycoprotein IIb/IIIa inhibitors are associated with a higher risk of bleeding than other antiplatelet drugs, especially in high-risk patients.To summarize, antiplatelet drugs play a crucial role in the management of ACS, and the efficacy and safety of these drugs have been well-established in the literature. The choice of antiplatelet drugs will depend on the patient's risk factors, including age, comorbidities, and bleeding risk. The novel antiplatelets may offer new therapeutic options for managing ACS, and further studies are needed to determine their role in managing this complex condition.

The Role of Antiplatelet in the Management of Sickle Cell Disease Patients

“…Future studies will focus on defining the optimal role of antiplatelet agents in conjunction with other treatments, such as regular blood transfusions, novel disease-modifying therapies, and supportive care measures. Understanding the potential interactions, additive effects, and long-term outcomes of combining antiplatelet therapy with these interventions is crucial for developing evidence-based treatment strategies [ 51 ]. Furthermore, large-scale clinical trials and long-term studies are needed to further investigate antiplatelet therapy's safety, efficacy, and optimal use in various clinical scenarios, including primary prevention, secondary prevention, and management of specific complications.…”

Advancements in Percutaneous Coronary Intervention Techniques: A Comprehensive Literature Review of Mixed Studies and Practice Guidelines

“…Advancements in DAPT have also resulted in the emergence of newer, more powerful antiplatelet drugs, such as prasugrel and ticagrelor. These drugs have demonstrated better efficacy than clopidogrel in reducing the risk of ischemia-related events following PCI [ 53 ]. The duration of DAPT may vary depending on patient characteristics, the type of stent utilized, and the likelihood of thrombotic events vs bleeding complications.…”