A Primer on Bleeding Risk and Management Strategies of Newer Oral Anti Platelet Agents in Cardiovascular Disease

S D Med. 2016 Oct;69(10):451-457.

Abstract

Aspirin, the first antiplatelet agent, has been around since the 19th century, and is one of the most established drugs in history. With the improvement of coronary interventions in the past few decades, there has been more reliance on oral antiplatelet agents to reduce complications of in-stent restenosis/thrombosis. Clopidogrel was initially introduced in 1997, and within the past seven years, two additional oral antiplatelet agents have been approved by the U.S. Food and Drug Administration. With more potent antiplatelet agents comes increased risks of adverse effects. Physicians of all fields should be aware of the common antiplatelet agents used today, and the basic landmark trials that allowed them to be on the market today. The focus of this review article is to evaluate each oral antiplatelet drug, its brief history, relevant trials, indications and management of complications through evidence based guidelines.

Publication types

  • Review

MeSH terms

  • Adenosine / adverse effects
  • Adenosine / analogs & derivatives
  • Adenosine / therapeutic use
  • Administration, Oral
  • Aspirin / adverse effects
  • Aspirin / therapeutic use
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / prevention & control*
  • Clopidogrel
  • Gastrointestinal Hemorrhage / chemically induced*
  • Humans
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prasugrel Hydrochloride / adverse effects
  • Prasugrel Hydrochloride / therapeutic use
  • Risk Factors
  • Thrombosis / prevention & control*
  • Ticagrelor
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Prasugrel Hydrochloride
  • Ticagrelor
  • Adenosine
  • Ticlopidine
  • Aspirin