This article is available online at http://www.jlr.org Thromboxane A 2 (TXA 2 ) is generated by thromboxane synthase metabolism of prostaglandin H 2 , the immediate product of cyclooxygenase (COX) action on arachidonic acid ( 1-3 ). Platelet COX-1, the only COX isoform expressed in mature platelets, is the dominant source of TXA 2 synthesis under normal conditions ( 4 ). Other cells, including macrophages and monocytes, contribute to TXA 2 generation via both COX-1 and COX-2 with the latter isozyme being particularly relevant during infl ammation ( 2, 5 ). TXA 2 acts as a local autocrine or paracrine mediator to mediate a range of physiological and pathophysiological responses that include platelet activation, vasoconstriction, and smooth muscle cell proliferation ( 3, 6-10 ). These processes are of particular relevance to cardiovascular disease (CVD) in which TXA 2 generation is markedly elevated and expression of its receptor, the TXA 2 receptor (TP), is increased ( 11-13 ). In humans, inhibition of platelet COX-1 with low-dose aspirin is widely used for prevention of heart attack and stroke ( 14-17 ), while in mouse models of atherogenesis and injury-induced vascular proliferation or remodeling, disease severity was blunted by antagonism or deletion of the TP ( 8,18,19 ). Interestingly, in hyperlipidemic mice the TP antagonist was more effective in reducing atherogenesis than COX inhibition ( 20 ). This may reflect antagonism of COX-independent TP ligands, such as the isoprostanes, free radical-derived metabolites of arachidonic acid that can activate the TP in vivo ( 21 ). These, and other studies, have placed signifi cant emphasis on the TP as a therapeutic target in CVD ( 8,20,22 ). Despite their potential, however, pharmacological antagonists of the TP have been