Skip to main content
Log in

Role of Antiplatelet Therapy in Secondary Prevention of Acute Coronary Syndrome

  • Published:
Journal of Cardiovascular Translational Research Aims and scope Submit manuscript

Abstract

Cardiovascular disease is one of the major causes of death in developed countries, mainly related to coronary artery disease and its acute complications. Platelets play a great role in the pathogenesis of acute thrombotic events of coronary artery disease when silent chronic disease becomes acutely symptomatic. Platelet importance in coronary artery disease and pathophysiology of acute events support the large benefit of antiplatelet agents for both acute management of ACS and secondary prevention. Recent developments in oral antiplatelet therapy raised questions about the choice of the molecules, the use of single or double therapy, and the optimal dosing and duration of treatment. The present review aims to provide a current appraisal of antiplatelet therapy use after ACS and to summarize available scientific evidence for an optimal use of antiplatelet agents in daily practice, including the new P2Y12 blockers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bhatt, D. L., Eagle, K. A., Ohman, E. M., et al. (2010). Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis. Journal of the American Medical Association, 304, 1350–1357.

    Article  PubMed  CAS  Google Scholar 

  2. Ruggeri, Z. M. (2002). Platelets in atherothrombosis. Nature Medicine, 8, 1227–1234.

    Article  PubMed  CAS  Google Scholar 

  3. Hansson, G. K. (2005). Inflammation, atherosclerosis, and coronary artery disease. The New England Journal of Medicine, 352, 1685–1695.

    Article  PubMed  CAS  Google Scholar 

  4. Roth, G. J., Stanford, N., & Majerus, P. W. (1975). Acetylation of prostaglandin synthase by aspirin. Proceedings of the National Academy of Sciences of the United States of America, 72, 3073–3076.

    Article  PubMed  CAS  Google Scholar 

  5. Patrono, C., Coller, B., FitzGerald, G. A., et al. (2004). Platelet-active drugs: the relationships among dose, effectiveness, and side effects: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 126(Suppl), 234S–264S.

    Article  PubMed  CAS  Google Scholar 

  6. Antithrombotic Trialists_ Collaboration. (2002). Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ, 324, 71–86.

    Article  Google Scholar 

  7. Antithrombotic Trialists’ (ATT) Collaboration, Baigent, C., Blackwell, L., & Collins, R. (2009). Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet, 373(9678), 1849–1860.

    Article  PubMed  Google Scholar 

  8. García Rodríguez, L. A., Hernández-Díaz, S., & de Abajo, F. J. (2001). Association between aspirin and upper gastrointestinal complications: systematic review of epidemiologic studies. British Journal of Clinical Pharmacology, 52, 563–571.

    Article  PubMed  Google Scholar 

  9. Sanderson, S., Emery, J., Baglin, T., et al. (2005). Narrative review: aspirin resistance and its clinical implications. Annals of Internal Medicine, 142, 370–380.

    PubMed  CAS  Google Scholar 

  10. Lordkipanidzé, M., Pharand, C., Schampaert, E., et al. (2007). A comparison of six major platelet function tests to determine the prevalence of aspirin resistance in patients with stable coronary artery disease. European Heart Journal, 28, 1702–1708.

    Article  PubMed  Google Scholar 

  11. Eikelboom, J. W., Hirsh, J., Weitz, J. I., et al. (2002). Aspirin resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events. Circulation, 105, 1650–1655.

    Article  PubMed  CAS  Google Scholar 

  12. Gum, P. A., Kottke-Marchant, K., Welsh, P. A., et al. (2003). A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease. Journal of the American College of Cardiology, 41, 961–965.

    Article  PubMed  CAS  Google Scholar 

  13. Chen, W. H., Lee, P. Y., Ng, W., et al. (2004). Aspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatment. Journal of the American College of Cardiology, 43, 1122–1126.

    Article  PubMed  CAS  Google Scholar 

  14. Cuisset, T., Frere, C., Quilici, J., et al. (2006). High post-treatment platelet reactivity identified low-responders to dual antiplatelet therapy at increased risk of recurrent cardiovascular events after stenting for acute coronary syndrome. Journal of Thrombosis and Haemostasis, 4, 542–549.

    Article  PubMed  CAS  Google Scholar 

  15. Gori, A. M., Marcucci, R., Migliorini, A., et al. (2008). Incidence and clinical impact of dual nonresponsiveness to aspirin and clopidogrel in patients with drug-eluting stents. Journal of the American College of Cardiology, 52(9), 734–739.

    Article  PubMed  CAS  Google Scholar 

  16. Cuisset, T., Frere, C., Quilici, J., et al. (2009). Aspirin non compliance is the major cause of “aspirin resistance” in patients undergoing coronary stenting. American Heart Journal, 157(5), 889–893.

    Article  PubMed  CAS  Google Scholar 

  17. Cuisset, T., Quilici, J., Fugon, L., et al. (2011). Non-adherence to aspirin in patients undergoing coronary stenting: negative impact of comorbid conditions and implications for clinical management. Archives of Cardiovascular Diseases, 104(5), 306–312.

    Article  PubMed  Google Scholar 

  18. Juul-Moller, S., Edvardsson, N., Jahnmatz, B., et al. (1992). Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet, 340, 1421–1425.

    Article  PubMed  CAS  Google Scholar 

  19. The RISC Group. (1990). Risk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. Lancet, 336, 827–830.

    Article  Google Scholar 

  20. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. (1988). Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. Lancet, 2, 349–360.

    Google Scholar 

  21. Peters, R. J., Mehta, S. R., Fox, K. A., & Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators. (2003). Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study. Circulation, 108(14), 1682–1687.

    Article  PubMed  CAS  Google Scholar 

  22. Mehta, S. R., Bassand, J. P., Chrolavicius, S., et al. (2010). CURRENT-OASIS 7 Investigators. Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. The New England Journal of Medicine, 363, 930–942.

    Article  PubMed  Google Scholar 

  23. Hamm CW, Bassand JP, Agewall S et al. (2011) ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. Sep 21. (in press).

  24. Van de Werf, F., Bax, J., Betriu, A., & ESC Committee for Practice Guidelines (CPG). (2008). Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. European Heart Journal, 29, 2909–2945.

    Article  PubMed  Google Scholar 

  25. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS), Wijns, W., Kolh, P., Danchin, N., et al. (2010). Guidelines on myocardial revascularization. European Heart Journal, 31, 2501–2555.

    Article  PubMed  Google Scholar 

  26. Hollopeter, G., Jantzen, H. M., Vincent, D., et al. (2001). Identification of the platelet ADP receptor targeted by antithrombotic drugs. Nature, 409, 202–207.

    Article  PubMed  CAS  Google Scholar 

  27. Savi, P., & Herbert, J. M. (2005). Clopidogrel and ticlopidine: P2Y12 adenosine diphosphate-receptor antagonists for the prevention of atherothrombosis. Seminars in Thrombosis and Hemostasis, 31, 174–183.

    Article  PubMed  CAS  Google Scholar 

  28. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996; 348: 1329–39.

  29. Yusuf, S., Zhao, F., Mehta, S. R., & Clopidogrel in Unstable Angina to Prevent Recurrent Events Trail Investigators. (2001). Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. The New England Journal of Medicine, 345, 494–502.

    Article  PubMed  CAS  Google Scholar 

  30. Mehta, S. R., Yusuf, S., Peters, R. J., & Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators. (2001). Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet, 358, 527.

    Article  PubMed  CAS  Google Scholar 

  31. Steinhubl, S. R., Berger, P. B., Mann, J. T., & CREDO Investigators. Clopidogrel for the Reduction of Events During Observation. (2002). Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. Journal of the American Medical Association, 288(19), 2411–2420.

    Article  PubMed  CAS  Google Scholar 

  32. Yusuf, S., Mehta, S. R., Zhao, F., et al. (2003). Early and late effects of clopidogrel in patients with acute coronary syndromes. Circulation, 107, 966.

    Article  PubMed  CAS  Google Scholar 

  33. Sabatine, M. S., Cannon, C. P., Gibson, C. M., & CLARITY-TIMI 28 Investigators. (2005). Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. The New England Journal of Medicine, 352, 1179.

    Article  PubMed  CAS  Google Scholar 

  34. Chen, Z. M., Pan, H. C., Chen, Y. P., & COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group. (2005). Early intravenous then oral metoprolol in 45 852 patients with acute myocardial infarction: randomised placebo-controlled trial. The Lancet, 366, 1622–1632.

    Article  CAS  Google Scholar 

  35. Bhatt, D. L., Fox, K. A. A., Hacke, W., et al. (2006). Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. The New England Journal of Medicine, 354, 1706–1717.

    Article  PubMed  CAS  Google Scholar 

  36. Pfeffer, M. A., & Jarcho, J. A. (2006). The charisma of subgroups and the subgroups of CHARISMA. The New England Journal of Medicine, 354, 1744–1746.

    Article  PubMed  CAS  Google Scholar 

  37. Bhatt, D. L., Flather, M. D., Hacke, W., et al. (2007). Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial. Journal of the American College of Cardiology, 49, 1982–1988.

    Article  PubMed  Google Scholar 

  38. Angiolillo, D. J., Fernandez-Ortiz, A., & Bernardo, E. (2007). Variability in individual responsiveness to clopidogrel: clinical implications, management, and future perspectives. JACC, 49(14), 1505–1516.

    PubMed  CAS  Google Scholar 

  39. Cuisset, T., Frere, C., Quilici, J., et al. (2006). Benefit of a 600-mg loading dose of clopidogrel on platelet reactivity and clinical outcomes in patients with non-ST-segment elevation acute coronary syndrome undergoing coronary stenting. Journal of the American College of Cardiology, 48, 1339–1345.

    Article  PubMed  CAS  Google Scholar 

  40. Montalescot, G., Sideris, G., & Meuleman, C. (2006). A randomized comparison of high clopidogrel loading doses in patients with non-ST-segment elevation acute coronary syndromes: the ALBION (Assessment of the Best Loading Dose of Clopidogrel to Blunt Platelet Activation, Inflammation and Ongoing Necrosis) trial. Journal of the American College of Cardiology, 48, 931–938.

    Article  PubMed  CAS  Google Scholar 

  41. Price, M. J., Berger, P. B., Teirstein, P. S., & GRAVITAS Investigators. (2011). Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. Journal of the American Medical Association, 305(11), 1097–1105.

    Article  PubMed  CAS  Google Scholar 

  42. Wiviott, S. D., Antman, E. M., Winters, K. J., et al. (2005). Randomized comparison of prasugrel (CS-747, LY640315), a novel thienopyridine P2Y12 antagonist, with clopidogrel in percutaneous coronary intervention: results of the Joint Utilization of Medications to Block Platelets Optimally (JUMBO)-TIMI 26 trial. Circulation, 111(25), 3366–3373.

    Article  PubMed  CAS  Google Scholar 

  43. Brandt, J. T., Payne, C. D., & Wiviott, S. D. (2007). A comparison of prasugrel and clopidogrel loading doses on platelet function: magnitude of platelet inhibition is related to active metabolite formation. American Heart Journal, 153(1), 66. e9-16.

    Article  PubMed  CAS  Google Scholar 

  44. Wiviott, S. D., Braunwald, E., McCabe, C. H., et al. (2007). Prasugrel versus clopidogrel in patients with acute coronary syndromes. The New England Journal of Medicine, 357, 2001–2015.

    Article  PubMed  CAS  Google Scholar 

  45. Jakubowski, J. A., Winters, K. J., Naganuma, H., et al. (2007). Prasugrel: a novel thienopyridine antiplatelet agent. A review of preclinical and clinical studies and the mechanistic basis for its distinct antiplatelet profile. Cardiovascular Drug Reviews, 25, 357–374.

    Article  PubMed  CAS  Google Scholar 

  46. Wallentin, L., Varenhorst, C., James, S., et al. (2008). Prasugrel achieves greater and faster P2Y12 receptor-mediated platelet inhibition than lopidogrel due to more efficient generation of its active metabolite in aspirin-treated patients with coronary artery disease. European Heart Journal, 29, 21–30.

    Article  PubMed  CAS  Google Scholar 

  47. Erlinge, D., Varenhorst, C., Braun, O. Ö., et al. (2008). Patients with poor responsiveness to thienopyridine treatment or with diabetes have lower levels of circulating active metabolite, but their platelets respond normally to active metabolite added ex vivo. Journal of the American College of Cardiology, 52, 1968–1977.

    Article  PubMed  CAS  Google Scholar 

  48. Michelson, A. D., Frelinger, A. L., III, Braunwald, E., TRITON-TIMI 38 Investigators, et al. (2009). Pharmacodynamic assessment of platelet inhibition by prasugrel vs clopidogrel in the TRITON-TIMI 38 trial. European Heart Journal, 30, 1753–1763.

    Article  PubMed  CAS  Google Scholar 

  49. Wiviott, S. D., & Braunwald, E. (2008). Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-thrombolysis in myocardial infarction 38. Circulation, 118, 1626–1636.

    Article  PubMed  CAS  Google Scholar 

  50. Montalescot, G., Wiviott, S. D., Braunwald, E., et al. (2009). Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST elevation myocardial infarction (TRITON-TIMI 38): double blind, randomised controlled trial. Lancet, 373, 723–731.

    Article  PubMed  CAS  Google Scholar 

  51. Chin, C. T., Roe, M. T., & Fox, K. A. A. (2010). Study design and rationale of a comparison of prasugrel and clopidogrel in medically managed patients with unstable angina/non-ST-segment elevation myocardial infarction: the TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medically manage Acute Coronary Syndromes (TRILOGY ACS) trial. American Heart Journal, 160, 16–22.e1.

    Article  PubMed  CAS  Google Scholar 

  52. Cannon, C. P., Husted, S., Harrington, R. A., DISPERSE-2 Investigators, et al. (2007). Safety, tolerability, and initial efficacy of AZD6140, the first reversible oral adenosine diphosphate receptor antagonist, compared with clopidogrel, in patients with non-ST-segment elevation acute coronary syndrome: primary results of the DISPERSE-2 trial. Journal of the American College of Cardiology, 50(19), 1844–1851.

    Article  PubMed  CAS  Google Scholar 

  53. Storey, R. F., Husted, S., Harrington, R. A., et al. (2007). Inhibition of platelet aggregation by AZD6140, a reversible oral P2Y12 receptor antagonist, compared with clopidogrel in patients with acute coronary syndromes. Journal of the American College of Cardiology, 50, 1852–1856.

    Article  PubMed  CAS  Google Scholar 

  54. Wallentin, L., Becker, R. C., Budaj, A., et al. (2009). Ticagrelor versus clopidogrel in patients with acute coronary syndromes. The New England Journal of Medicine, 361, 1045–1057.

    Article  PubMed  CAS  Google Scholar 

  55. James, S., Budaj, A., Aylward, P., et al. (2010). Ticagrelor versus clopidogrel in acute coronary syndromes in relation to renal function: results from the Platelet Inhibition and Patient Outcomes (PLATO) trial. Circulation, 122(11), 1056–1067.

    Article  PubMed  Google Scholar 

  56. Lip, G. Y., Huber, K., & Andreotti, F. (2010). Consensus Document of European Society of Cardiology Working Group on Thrombosis Antithrombotic management of atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing coronary stenting: executive summary--a Consensus Document of the European Society of Cardiology Working Group on Thrombosis, endorsed by the European Heart Rhythm Association (EHRA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European Heart Journal, 11, 1311–1318.

    Article  Google Scholar 

  57. Angiolillo, D. J., Bernardo, E., & Sabate, M. (2007). Impact of platelet reactivity on cardiovascular outcomes in patients with type 2 diabetes mellitus and coronary artery disease. Journal of the American College of Cardiology, 50, 1541–1547.

    Article  PubMed  Google Scholar 

  58. Hulot, J., Bura, A., Villard, E., et al. (2006). Cytochrome P450 2C19 loss-of-function polymorphism is a major determinant of clopidogrel responsiveness in healthy subjects. Blood, 108, 2244–2247.

    Article  PubMed  CAS  Google Scholar 

  59. Shuldiner, A. R., O_connell, J. R., & Bliden, K. P. (2009). Association of cytochrome P450 2 C19 genotype with the antiplatelet effect and clinical efficacy of clopidogrel therapy. Journal of the American Medical Association, 302, 849–857.

    Article  PubMed  CAS  Google Scholar 

  60. Mega, J. L., Simon, T., Collet, J., et al. (2010). Reduced-function CYP2C19 genotype and risk of adverse clinical outcomes among patients treated with clopidogrel predominantly for PCI: a meta-analysis. Journal of the American Medical Association, 304, 1821–1830.

    Article  PubMed  CAS  Google Scholar 

  61. Matetzky, S., Shenkman, B., & Guetta, V. (2004). Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction. Circulation, 109, 3171–3175.

    Article  PubMed  CAS  Google Scholar 

  62. Geisler, T., Langer, H., Wydymus, M., et al. (2006). Low response to clopidogrel is associated with cardiovascular outcome after coronary stent implantation. European Heart Journal, 27, 2420–2425.

    Article  PubMed  CAS  Google Scholar 

  63. Hochholzer, W., Trenk, D., Bestehorn, H. P., et al. (2006). Impact of the degree of peri-interventional platelet inhibition after loading with clopidogrel on early clinical outcome of elective coronary stent placement. Journal of the American College of Cardiology, 48, 1742–1750.

    Article  PubMed  CAS  Google Scholar 

  64. Buonamici, P., Marcucci, R., Migliorini, A., et al. (2007). Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis. Journal of the American College of Cardiology, 49, 2312–2317.

    Article  PubMed  CAS  Google Scholar 

  65. Cuisset, T., Cayla, G., & Frere, C. (2009). Predictive value of post-treatment platelet reactivity for occurrence of post-discharge bleeding after non-ST elevation acute coronary syndrome. Shifting from antiplatelet resistance to bleeding risk assessment? EuroIntervention, 5, 325–329.

    Article  PubMed  Google Scholar 

  66. Sibbing, D., Schulz, S., Braun, S., et al. (2010). Antiplatelet effects of clopidogrel and bleeding in patients undergoing coronary stent placement. Journal of Thrombosis and Haemostasis, 8, 250–256.

    Article  PubMed  CAS  Google Scholar 

  67. Gilard, M., Arnaud, B., Cornily, J. C., et al. (2008). Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study. Journal of the American College of Cardiology, 51, 256.

    Article  PubMed  CAS  Google Scholar 

  68. Cuisset, T., Frere, C., Quilici, J., et al. (2009). Comparison of omeprazole and pantoprazole influence on a high 150-mg clopidogrel maintenance dose the PACA (Proton Pump Inhibitors And Clopidogrel Association) prospective randomized study. Journal of the American College of Cardiology, 54, 1149.

    Article  PubMed  CAS  Google Scholar 

  69. Evanchan, J., Donnally, M. R., Binkley, P., et al. (2010). Recurrence of acute myocardial infarction in patients discharged on clopidogrel and a proton pump inhibitor after stent placement for acute myocardial infarction. Clinical Cardiology, 33, 168.

    Article  PubMed  Google Scholar 

  70. Ray, W. A., Murray, K. T., Griffin, M. R., et al. (2010). Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study. Annals of Internal Medicine, 152, 337.

    PubMed  Google Scholar 

  71. Gaglia, M. A., Jr., Torguson, R., & Hanna, N. (2010). Relation of proton pump inhibitor use after percutaneous coronary intervention with drug-eluting stents to outcomes. The American Journal of Cardiology, 105, 833.

    Article  PubMed  CAS  Google Scholar 

  72. Kwok, C. S., & Loke, Y. K. (2010). Meta-analysis: the effects of proton pump inhibitors on cardiovascular events and mortality in patients receiving clopidogrel. Alimentary Pharmacology and Therapeutics, 31, 810.

    PubMed  CAS  Google Scholar 

  73. Bhatt, D. L., Cryer, B. L., Contant, C. F., & COGENT Investigators. (2010). Clopidogrel with or without omeprazole in coronary artery disease. The New England Journal of Medicine, 363, 1909.

    Article  PubMed  CAS  Google Scholar 

  74. Bates, E. R., Lau, W. C., & Angiolillo, D. J. (2011). Clopidogrel-drug interactions. Journal of the American College of Cardiology, 57, 1251.

    Article  PubMed  CAS  Google Scholar 

  75. Saw, J., Brennan, D. M., Steinhubl, S. R., et al. (2007). Lack of evidence of a clopidogrel-statin interaction in the CHARISMA trial. Journal of the American College of Cardiology, 50, 291.

    Article  PubMed  CAS  Google Scholar 

  76. Angiolillo, D. J., & Alfonso, F. (2007). Clopidogrel-statin interaction: myth or reality? Journal of the American College of Cardiology, 50, 296.

    Article  PubMed  CAS  Google Scholar 

  77. Trenk, D., Hochholzer, W., Frundi, D., et al. (2008). Impact of cytochrome P450 3A4-metabolized statins on the antiplatelet effect of a 600-mg loading dose clopidogrel and on clinical outcome in patients undergoing elective coronary stent placement. Thrombosis and Haemostasis, 99, 174.

    PubMed  CAS  Google Scholar 

  78. Siller-Matula, J. M., Lang, I., Christ, G., et al. (2008). Calcium-channel blockers reduce the antiplatelet effect of clopidogrel. Journal of the American College of Cardiology, 52, 1557.

    Article  PubMed  CAS  Google Scholar 

  79. Olesen, J. B., Gislason, G. H., Charlot, M. G., et al. (2011). Calcium-channel blockers do not alter the clinical efficacy of clopidogrel after myocardial infarction: a nationwide cohort study. Journal of the American College of Cardiology, 57, 409.

    Article  PubMed  CAS  Google Scholar 

  80. Frere, C., Cuisset, T., Gaborit, B., et al. (2008). The CYP2C19*17 allele is associated with better platelet response to clopidogrel in patients admitted for non-ST acute coronary syndrome. Journal of Thrombosis and Haemostasis, 7, 1409–1411.

    Article  Google Scholar 

  81. Collet, J. P., Hulot, J. S., Pena, A., et al. (2009). Cytochrome P450 2 C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study. Lancet, 373, 309–317.

    Article  PubMed  CAS  Google Scholar 

  82. Bonello, L., Camoin-Jau, L., Arques, S., Boyer, C., Panagides, D., Wittenberg, O., et al. (2008). Adjusted clopidogrel loading doses according to vasodilator-stimulated phosphoprotein phosphorylation index decrease rate of major adverse cardiovascular events in patients with clopidogrel resistance: a multicenter randomized prospective study. Journal of the American College of Cardiology, 51, 1404–1411.

    Article  PubMed  CAS  Google Scholar 

  83. Cuisset, T., Frere, C., Quilici, J., Morange, P. E., Mouret, J. P., Bali, L., et al. (2008). Glycoprotein IIb/IIIa inhibitors improve outcome after coronary stenting in clopi dogrel non-responders: a prospective, randomized study. JACC. Cardiovascular Interventions, 1, 649–653.

    Article  PubMed  Google Scholar 

  84. Valgimigli, M., Campo, G., de Cesare, N., Meliga, E., Vranckx, P., Furgieri, A., et al. (2009). Intensifying platelet inhibition with tirofiban in poor responders to aspirin, clopidogrel, or both agents undergoing elective coronary intervention: results from the double-blind, prospective, randomized tailoring treatment with tirofiban in patients showing resistance to aspirin and/or resistance to clopidogrel study. Circulation, 119, 3215–3222.

    Article  PubMed  CAS  Google Scholar 

  85. Price, M. J., Berger, P. B., Teirstein, P. S., Tanguay, J. F., Angiolillo, D. J., Spriggs, D., et al. (2011). Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. Journal of the American Medical Association, 305, 1097–1105.

    Article  PubMed  CAS  Google Scholar 

  86. Spertus, J., Kettelkamp, R., Vance, C., et al. (2006). Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation, 113, 2803–2809.

    Article  PubMed  CAS  Google Scholar 

  87. Horwitz, R. I., Viscoli, C. M., Berkman, L., et al. (1990). Treatment adherence and risk of death after a myocardial infarction. Lancet, 336, 542–545.

    Article  PubMed  CAS  Google Scholar 

  88. Gallagher, E. J., Viscoli, C. M., & Horwitz, R. I. (1993). The relationship of treatment adherence to the risk of death after myocardial infarction in women. Journal of the American Medical Association, 270, 742–744.

    Article  PubMed  CAS  Google Scholar 

  89. Iakovou, I., Schmidt, T., Bonizzoni, E., et al. (2005). Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. Journal of the American Medical Association, 293, 2126–2130.

    Article  PubMed  CAS  Google Scholar 

  90. Collet, J. P., Montalescot, G., Blanchet, B., et al. (2004). Impact of prior use or recent withdrawal of oral antiplatelet agents on acute coronary syndromes. Circulation, 110, 2361–2367.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thomas Cuisset.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pankert, M., Quilici, J. & Cuisset, T. Role of Antiplatelet Therapy in Secondary Prevention of Acute Coronary Syndrome. J. of Cardiovasc. Trans. Res. 5, 41–51 (2012). https://doi.org/10.1007/s12265-011-9329-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12265-011-9329-4

Keywords

Navigation