Antithrombotic strategies in patients undergoing percutaneous coronary intervention for acute coronary syndrome

Son V. Pham, Phuong Chi T. Pham, Phuong Mai T. Pham, Jeffrey M. Miller, Phuong Thum T. Pham, Phuong Anh T. Pham

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

In patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), both periprocedural acute myocardial infarction and bleeding complications have been shown to be associated with early and late mortality. Current standard antithrombotic therapy after coronary stent implantation consists of lifelong aspirin and clopidogrel for a variable period depending in part on the stent type. Despite its well-established efficacy in reducing cardiac-related death, myocardial infarction, and stroke, dual antiplatelet therapy with aspirin and clopidogrel is not without shortcomings. While clopidogrel may be of little beneficial effect if administered immediately prior to PCI and may even increase major bleeding risk if coronary artery bypass grafting is anticipated, early discontinuation of the drug may result in insufficient antiplatelet coverage with thrombotic complications. Optimal and rapid inhibition of platelet activity to suppress ischemic and thrombotic events while minimizing bleeding complications is an important therapeutic goal in the management of patients undergoing percutaneous coronary intervention. In this article we present an overview of the literature on clinical trials evaluating the different aspects of antithrombotic therapy in patients undergoing PCI and discuss the emerging role of these agents in the contemporary era of early invasive coronary intervention. Clinical trial acronyms and their full names are provided in Table 1.

Original languageEnglish (US)
Pages (from-to)203-220
Number of pages18
JournalDrug Design, Development and Therapy
Volume4
DOIs
StatePublished - 2010
Externally publishedYes

Keywords

  • Acute coronary syndrome
  • Aspirin
  • Bivalirudin
  • Clopidogrel
  • Glycoprotein IIb/IIIa inhibitors
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science
  • Drug Discovery

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