Current oral antiplatelets

Focus update on prasugrel

Jinu John, Santhosh Koshy

Research output: Contribution to journalReview article

13 Citations (Scopus)

Abstract

Platelet activation and aggregation plays an integral role in the pathogenesis of acute coronary syndrome (ACS). The mainstay of ACS treatment revolves around platelet inhibition. It is known that greater platelet inhibition results in better ischemic outcomes; hence, focus in drug development has been to create more potent inhibitors of platelet aggregation. Prasugrel, a potent, thirdgeneration thienopyridine, was approved by the US Food and Drug Administration in July 2009 for its use in ACS and percutaneous coronary intervention. The addition of prasugrel to aspirin for dual antiplatelet therapy has been shown to reduce the ischemic outcomes compared with clopidogrel and aspirin in combination. However, being a more potent antiplatelet agent, prasugrel increases the risk of bleeding, especially in those patients who are at a higher risk of bleeding complications. Elderly patients ≥75 years, patients who weigh ≥60 kg, and patients with a history of stroke or transient ischemic attack are at a higher risk of bleeding complications when prasugrel is used in combination with aspirin. Newer antiplatelets currently are being clinically evaluated to assess their efficacy in reducing ischemic events without increasing the bleeding risk.

Original languageEnglish (US)
Pages (from-to)343-349
Number of pages7
JournalJournal of the American Board of Family Medicine
Volume25
Issue number3
DOIs
StatePublished - May 2012

Fingerprint

Acute Coronary Syndrome
Hemorrhage
Aspirin
clopidogrel
Platelet Aggregation Inhibitors
Blood Platelets
Transient Ischemic Attack
Platelet Activation
Percutaneous Coronary Intervention
United States Food and Drug Administration
Platelet Aggregation
Stroke
Prasugrel Hydrochloride
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Family Practice

Cite this

Current oral antiplatelets : Focus update on prasugrel. / John, Jinu; Koshy, Santhosh.

In: Journal of the American Board of Family Medicine, Vol. 25, No. 3, 05.2012, p. 343-349.

Research output: Contribution to journalReview article

@article{5581945ff87342e48e784e5c23542bef,
title = "Current oral antiplatelets: Focus update on prasugrel",
abstract = "Platelet activation and aggregation plays an integral role in the pathogenesis of acute coronary syndrome (ACS). The mainstay of ACS treatment revolves around platelet inhibition. It is known that greater platelet inhibition results in better ischemic outcomes; hence, focus in drug development has been to create more potent inhibitors of platelet aggregation. Prasugrel, a potent, thirdgeneration thienopyridine, was approved by the US Food and Drug Administration in July 2009 for its use in ACS and percutaneous coronary intervention. The addition of prasugrel to aspirin for dual antiplatelet therapy has been shown to reduce the ischemic outcomes compared with clopidogrel and aspirin in combination. However, being a more potent antiplatelet agent, prasugrel increases the risk of bleeding, especially in those patients who are at a higher risk of bleeding complications. Elderly patients ≥75 years, patients who weigh ≥60 kg, and patients with a history of stroke or transient ischemic attack are at a higher risk of bleeding complications when prasugrel is used in combination with aspirin. Newer antiplatelets currently are being clinically evaluated to assess their efficacy in reducing ischemic events without increasing the bleeding risk.",
author = "Jinu John and Santhosh Koshy",
year = "2012",
month = "5",
doi = "10.3122/jabfm.2012.03.100270",
language = "English (US)",
volume = "25",
pages = "343--349",
journal = "Journal of the American Board of Family Medicine",
issn = "1557-2625",
publisher = "American Board of Family Medicine",
number = "3",

}

TY - JOUR

T1 - Current oral antiplatelets

T2 - Focus update on prasugrel

AU - John, Jinu

AU - Koshy, Santhosh

PY - 2012/5

Y1 - 2012/5

N2 - Platelet activation and aggregation plays an integral role in the pathogenesis of acute coronary syndrome (ACS). The mainstay of ACS treatment revolves around platelet inhibition. It is known that greater platelet inhibition results in better ischemic outcomes; hence, focus in drug development has been to create more potent inhibitors of platelet aggregation. Prasugrel, a potent, thirdgeneration thienopyridine, was approved by the US Food and Drug Administration in July 2009 for its use in ACS and percutaneous coronary intervention. The addition of prasugrel to aspirin for dual antiplatelet therapy has been shown to reduce the ischemic outcomes compared with clopidogrel and aspirin in combination. However, being a more potent antiplatelet agent, prasugrel increases the risk of bleeding, especially in those patients who are at a higher risk of bleeding complications. Elderly patients ≥75 years, patients who weigh ≥60 kg, and patients with a history of stroke or transient ischemic attack are at a higher risk of bleeding complications when prasugrel is used in combination with aspirin. Newer antiplatelets currently are being clinically evaluated to assess their efficacy in reducing ischemic events without increasing the bleeding risk.

AB - Platelet activation and aggregation plays an integral role in the pathogenesis of acute coronary syndrome (ACS). The mainstay of ACS treatment revolves around platelet inhibition. It is known that greater platelet inhibition results in better ischemic outcomes; hence, focus in drug development has been to create more potent inhibitors of platelet aggregation. Prasugrel, a potent, thirdgeneration thienopyridine, was approved by the US Food and Drug Administration in July 2009 for its use in ACS and percutaneous coronary intervention. The addition of prasugrel to aspirin for dual antiplatelet therapy has been shown to reduce the ischemic outcomes compared with clopidogrel and aspirin in combination. However, being a more potent antiplatelet agent, prasugrel increases the risk of bleeding, especially in those patients who are at a higher risk of bleeding complications. Elderly patients ≥75 years, patients who weigh ≥60 kg, and patients with a history of stroke or transient ischemic attack are at a higher risk of bleeding complications when prasugrel is used in combination with aspirin. Newer antiplatelets currently are being clinically evaluated to assess their efficacy in reducing ischemic events without increasing the bleeding risk.

UR - http://www.scopus.com/inward/record.url?scp=84861868456&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861868456&partnerID=8YFLogxK

U2 - 10.3122/jabfm.2012.03.100270

DO - 10.3122/jabfm.2012.03.100270

M3 - Review article

VL - 25

SP - 343

EP - 349

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

SN - 1557-2625

IS - 3

ER -