Fang Jing and Wei Zhang
Platelet adhesion, activation and aggregation to the injured vessel wall are crucially involved in the pathogenesis of thrombus formation. Agents in theory thwarting these phases would have significant clinical value. The current antiplatelet drugs used in daily clinical practice include COX-1 inhibitor aspirin, ADP P2Y12 receptor antagonist clopidogrel, and the GPIIb-IIIa antagonists (abciximab, eptifibatide and tirofiban). However, confined curative ratio along with unforeseen bleeding risk remains a major puzzle of antiplatelet therapy. With advances in understanding of the molecular basis of platelet in thrombosis, newer antiplatelet agents that targets different stage of thrombus formation have been recently developed, mostly including agents targeting platelet adhesion (GPIV, vWF), activation (GPVI, P2Y12, TPα, PAR1, phosphodiesterase, cyclooxygenase), and aggregation (GPIIb/IIIa). In this article, we will review the advantages and limitations of various antiplatelet agents that have been approved by the US Food and Drug Administration (FDA) or under development.
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