P2Y₁₂Platelet Receptors: Importance in Percutaneous Coronary Intervention

Abstract

Apart from their role in hemostasis and thrombosis, platelets are involved in many other biological processes such as wound healing and angiogenesis. Percutaneous coronary intervention is a highly thrombogenic procedure inducing platelets and monocytes activation through endothelial trauma and contact activation by intravascular devices. Platelet P2Y12 receptor activation by adenosine diphosphate facilitates non-ADP agonist-mediated platelet aggregation, dense granule secretion, procoagulant activity, and the phosphorylation of several intraplatelet proteins, making it an ideal drug target. However, not all compounds that target the P2Y12 receptor have similar efficacy and safety profiles. Despite targeting the same receptor, the unique pharmacologic properties of each of these P2Y12 receptor-directed compounds can lead to very different clinical effects.

Statins Reduce Peri-procedural Complications in Carotid Stenting

“…Stent-angioplasty induced effects such as platelet activation, thrombosis, and inflammatory processes within the vessel wall appear to be attenuated by statins. 21,22 Accordingly, peri-interventional risk reduction in stenting is an essential issue, and the benefit of statin use before stenting has to be evaluated, not least because little evidence is available currently for peri-procedural drug therapy in carotid artery stenting. 23 The aim of this study was to investigate the effect of pre-procedural statin medication on the risk of peri-procedural stroke, myocardial infarction, and mortality in a set of patients at a specialized center treated with stent-angioplasty for extracranial carotid stenoses.…”

Perfil epidemiológico e clínico de pacientes com síndrome coronariana aguda

“…Although antithrombotic drugs are essential for the treatment and secondary prevention of ACS, they should be used with caution. 17 Opioids were also used in the majority of patients diagnosed with AMI of this investigation. Such drugs are recommended for pain relief, anxiety and have adjuvant vasodilator action.…”

The Personalization of Clopidogrel Antiplatelet Therapy: The Role of Integrative Pharmacogenetics and Pharmacometabolomics

“…The PFT assessment of antiplatelet drugs relies on the measurement of platelets inhibition which happened due to the effect of the drug. There are different PFT instruments which are widely used to assess antiplatelet drugs such as the optical light transmission aggregometry (LTA) [105], the VerifyNow® system (VN) (Accumetrics Inc., San Diego, California) [106], the vasodilator stimulated phosphoprotein phosphorylation assay (VASP-P) [107, 108], the multiple electrode platelet aggregometry (MEA) [105], the platelets function analyser (PFA-100) [109–111], the Impact-R assay [110], and the platelet-works® (PW) [110]. The PFT instruments have different techniques, agonist reagents, and testing kits to test different classes of antiplatelet drugs [105, 109].…”

“…The results of PFT instruments which utilize platelets aggregation technique for measurement are highly affected by concomitant use of other antiplatelet drugs such as GPIIb-IIIa antagonists [119]. In fact, the simulation nature of PFT by using agonist in an in vitro setting to stimulate platelets activation does not perfectly resemble the physiological process of platelets activation which is affected by many internal pathways [108]. This may lead to PFT results that do not reflect the actual platelets function of the patients.…”