Advanced search
Publication Cover
Expert Review of Cardiovascular Therapy Volume 10, 2012 - Issue 12
Submit an article Journal homepage
119
Views
8
CrossRef citations to date
0
Altmetric
Theme: Thrombosis - Perspective

Antiplatelets in acute coronary syndrome: personal perspectives

Rossella Marcucci Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy. [email protected]
,
Caterina Cenci Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
,
Gabriele Cioni Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
,
Alessandra Lombardi Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
,
Betti Giusti Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
&
Gian Franco Gensini Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy
Pages 1487-1496 | Published online: 10 Jan 2014
 
Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days

Abstract

High platelet reactivity (HPR) during dual-antiplatelet therapy is a marker of vascular risk, in particular stent thrombosis, in patients with acute coronary syndromes. Genetic determinants (CYP2C19*2 polymorphism), advanced age, female gender, diabetes and reduced ventricular function are related to a higher risk to develop HPR. In addition, inflammation and increased platelet turnover, as revealed by the elevated percentage of reticulate platelets in patients’ blood, that characterize the acute phase of acute coronary syndrome are associated with HPR. To overcome the limitation of clopidogrel, new antiplatelet agents (prasugrel and ticagrelor) were developed and the demonstration of their superiority over clopidogrel was obtained in the two randomized trials, TRITON TIMI 38 and PLATO. Due to the current possibility not a choice between multiple antiplatelet strategies, the future prospect is to include, in addition to clinical data and classical risk factors, the definition of platelet function during treatment in order to set a tailored therapy.

Financial & competing interests disclosure

R Marcucci has received honoraria for lectures from Daiichi Sankyo/Eli Lilly and Merck Sharp & Dohme, Instrumentation Laboratory and Hemonetics. GF Gensini has reported receiving consulting fees from Bayer, Boehringer Ingelheim and Eli Lilly; and lecture fees from AstraZeneca, GlaxoSmithKline, Instrumentation Laboratory, Menarini and Sigma Tau; as well as research grant funding from Novo Nordisk, Merck Sharp & Dohme, Pfizer, Pierrel, Sanofi-Aventis and Servier. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Log in via your institution

Access through your institution

Log in to Taylor & Francis Online

Restore content access

Restore content access for purchases made as guest
Purchase options * Save for later

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 99.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 611.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.