Role of Antiplatelet Therapies in Preventing Atherothrombosis

Abstract

Platelets exhibit a major role in development and progression of atherothrombosis. The normal function of platelets is to secure hemostasis at sites of vascular injuries. Abnormal endovascular structure may result in excessive platelet function with consequence of progressive or acute reduction in vascular lumen and cessation of blood flow. Despite succeeding in averting bleeding, total occlusion of a vessel leads to inevitable ischemia with eventual cell death upon lack of blood supply clinically manifesting as myocardial infarction in coronary vessels, cerebral infarction (stroke) in cerebral vessels, or peripheral gangrene in peripheral arterial disease. Antiplatelets long have been used to halt the process of atherothrombosis preventing further tissue damage at the expense of bleeding as well as other side effects. In this review, the role of antiplatelets in primary and secondary prevention of thrombotic events is explored in light of evidence based clinical practice.

A Review on Antiplatelet Drugs and Anticoagulants

“…These drugs prevent the final common pathway of platelet formation where fibrinogen binds to GP IIb/IIIa receptor [8] Thienopyridines: The antiplatelet activities of the indirectly acting thienopyridines are delayed as a consequence of the need for metabolism of the prodrug. Furthermore, there are considerable interindividual discrepancies in the degree of metabolism of the prodrug leading to unpredictability in platelet inhibition [9].…”

Role of Antiplatelet Therapy in Stroke Prevention in Patients With Atrial Fibrillation

“…comorbidities such as diabetes, hypertension, and atherosclerosis promote cardiac remodeling by causing left atrial dilation and endothelial dysfunction. 14 15 When activated, platelets release storage granules, which promote platelet aggregation. 15,16…”