New antiplatelet drugs

Abstract

Many clinical trials and pathologic analyses have clearly demonstrated a central role for platelets in the pathophysiology of major cardiovascular disorders, including unstable angina pectoris, acute myocardial infarction (MI), transient ischaemia, and stroke following thrombolytic therapy [1,2]. A meta-analysis of 25 randomised trials of various antiplatelet agents that included 29,000 patients revealed a highly significant decrease in non-fatal MI, stroke, total cardiovascular death, and overall mortality in patients treated with antiplatelet agents compared with placebo [3]. These data have triggered intense efforts over the past 10 years in studying the role of the platelet in cardiovascular disorders, and in developing more potent and selective antiplatelet agents. This discussion summarises recent advances in the development and evaluation of these newer agents with particular emphasis on antagonists of the glycoprotein (GP) IIb/IIIa receptor, since this protein plays a key role in the final common pathway of platelet aggregation.