Antiplatelet agents in coronary artery disease

B. J. Schrader, Steven Ira Berk

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Coronary artery disease pathophysiology and platelet physiology are summarized, and the use of antiplatelet drugs in coronary artery disease is reviewed. Aspririn, sulfinpyrazone, and most other nonsteroidal anti-inflammatory agents alter platelet function by inhibiting the activity of cyclooxygenase, an enzyme nescessary for the production of prostaglandins. Drugs that inhibit thromboxane synthetase or antagonize thromboxane A2 at the receptor level are under investigation. Prostacyclin and dipyridamole inhibit platelet function by elevating the concentration of cyclic AMP in platelets, but proof of their efficacy is limited. Most clinical trials of antiplatelet drugs in coronary artery disease have been small and of short duration; many have demonstrated short-term benefits but long-term benefits are less obvious. Retrospective studies of patients before initial myocardial infarction suggest that regular aspirin ingestion may reduce the occurrence of cardiovascular complications. In prospective trials, the benefit of aspirin therapy for primary prevention of coronary artery disease was balanced by an increased likelihood of stroke. For secondary - after initial infarction - prevention of cardiovascular complications, the administration of aspirin and other antiplatelet agents has consistently decreased the rate of nonfatal myocardial infarction, overall mortality, or both. In the Second International Study of Infarct Survival, patients treated with streptokinase plus aspirin showed the greates reduction in mortality, while each drug alone was associated with significantly lower mortality than placebo. Aspirin may improve clinical outcome in patients with or without previous myocardial infarction or with usntable angina pectoris. The daily dose should not exceed 325 mg. Antiplatelet therapy should not be used in patients at high risk for bleeding.

Original languageEnglish (US)
Pages (from-to)118-124
Number of pages7
JournalClinical Pharmacy
Volume9
Issue number2
StatePublished - 1990
Externally publishedYes

Fingerprint

Platelet Aggregation Inhibitors
Aspirin
Coronary Artery Disease
Blood Platelets
Myocardial Infarction
Mortality
Sulfinpyrazone
Thromboxane-A Synthase
Prostaglandin H2 Receptors Thromboxane A2
Streptokinase
Dipyridamole
Angina Pectoris
Non-Steroidal Anti-Inflammatory Agents
Epoprostenol
Primary Prevention
Prostaglandin-Endoperoxide Synthases
Pharmaceutical Preparations
Cyclic AMP
Infarction
Prostaglandins

Keywords

  • Aspirin
  • coronary disease
  • dipyridamole
  • platelet aggregation inhibitors
  • prostacyclin
  • sulfinpyrazone

ASJC Scopus subject areas

  • Pharmaceutical Science

Cite this

Antiplatelet agents in coronary artery disease. / Schrader, B. J.; Berk, Steven Ira.

In: Clinical Pharmacy, Vol. 9, No. 2, 1990, p. 118-124.

Research output: Contribution to journalArticle

Schrader, BJ & Berk, SI 1990, 'Antiplatelet agents in coronary artery disease', Clinical Pharmacy, vol. 9, no. 2, pp. 118-124.
Schrader, B. J. ; Berk, Steven Ira. / Antiplatelet agents in coronary artery disease. In: Clinical Pharmacy. 1990 ; Vol. 9, No. 2. pp. 118-124.
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