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Ann Thorac Surg 2000;70:S3-S8
© 2000 The Society of Thoracic Surgeons

Antiplatelet agents in cardiology: the choice of therapy

Steven R. Steinhubl, MDa

a Department of Cardiology, Wilford Hall Medical Center, Lackland AFB, Texas, USA

Address reprint requests to Dr Steinhubl, Department of Cardiology, Wilford Hall Medical Center, 2200 Bergquist Dr, Lackland AFB, TX 78236-5300

Presented at the "Managing the Patient Receiving Platelet Inhibitors in Cardiac Surgery" Roundtable Discussion, San Antonio, TX, Jan 22–23, 1999.

Background. The platelet-rich, intracoronary thrombus is central to the pathogenesis of acute myocardial infarctions, unstable angina, and the majority of complications of percutaneous coronary interventions. Until recently, aspirin was the only antiplatelet agent available to help prevent or treat these events. Over the past several years, there has been a substantial expansion in our antiplatelet armamentarium as well as in our understanding of the clinical importance of antiplatelet therapy in limiting the complications of intracoronary thrombosis. Because of this, it is likely that over the coming years, the use of antiplatelet therapies will continue to expand, and it may not be unusual for a surgeon to encounter a patient being treated with two or even three platelet inhibitors.

Conclusions. This review will highlight the benefits and limitations of the currently available antiplatelet regimens: aspirin, thienopyridines (ticlopidine and clopidogrel), and the platelet glycoprotein IIb/IIIa inhibitors.






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Copyright © 2000 by The Society of Thoracic Surgeons.