Current developments in anti-platelet therapy

Platelets play a life-saving role in hemostasis and blood clotting at sites of vascular injury and consequently are similarly involved in the pathological counterpart, namely thrombosis. Thus, anti-platelet therapy has become a mainstay in treatment and/or prophylaxis of conditions like myocardial infarction, stroke and other cardiovascular diseases. Acetyl-salicylic acid (ASA, aspirin (R)) is still the most widely used agent and considered as the prototype antiplatelet drug. Since platelet activation occurs via several pathways that are not influenced by ASA, several other compounds have been developed to add to its beneficial effect. Currently four main classes of antiplatelet agents are available for clinical use: acetyl-salicylic acid (ASA), phosphodiesterase (PDE) inhibitors, thienopyridines and the intravenous GPIIb/IIIa antagonists. This article gives a concise review of these four classes of anti-platelet agents, using ASA as the reference standard.