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Overview of pleiotropic effects of platelet P2Y12receptor inhibitors

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH13-11-0915
Issue: 2014: 112/2 (Aug) pp. 223-426
Pages: 224-242
Ahead of Print: 2014-04-24

Overview of pleiotropic effects of platelet P2Y12receptor inhibitors

P. Adamski (1), M. Koziński (1), M. Ostrowska (1), T. Fabiszak (2), E. P. Navarese (2), P. Paciorek (3), G. Grześk (2, 4), J. Kubica (2)

(1) Department of Principles of Clinical Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; (2) Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; (3) Department of Emergency Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; (4) Department of Pharmacology and Therapy, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

Keywords

clopidogrel, prasugrel, P2Y12 receptor, ticagrelor, off-target effect

Summary

Dual antiplatelet therapy consisting of one of the P2Y12 receptor inhibitors in conjunction with aspirin is the mainstay of treatment for patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary interventions (PCI). In recent years, multiple extra-platelet features of P2Y12 receptor antagonists have been reported in numerous clinical trials. The aim of this review is to summarise reported pleiotropic effects of clopidogrel, prasugrel, ticagrelor and other P2Y12 receptor blockers. We included observations made both in human and in animal models, together with proposed mechanisms of action for described features. If confirmed in randomised studies and properly applied to everyday practice, the observed extra-platelet actions could enable us to improve efficacy of ACS and post-PCI treatment, as well as to confine mortality and occurrence rate of cardiovascular events.

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