Angelika Bátorová
Antiplatelet agents are essential components of prevention and treatment of arterial thrombosis, which is an important pathogenetic factor of clinical manifestation of the coronary, cerebral and peripheral arterial atherosclerosis. Classical antiplatelet agents are represented by acetylsalicic acid, which is appropriate for lifelong therapy in patients with acute and chronic coronary syndromes. Clopidogrel is recommended for most patients with acute coronary syndromes either for short- or long-term therapy, depending on the patient’s level of risk. Glycoprotein IIbIIIa (GPIIbIIIa) antagonists along with clopidogrel are used for management of acute coronary events. Currently available antiplatelet drugs have some limitations which might be overcomed by improved dosing regimens, use of combination of agents affecting different platelet functions and, in particular, by the new antiplatelet agents with distinct pharmacological properties offering new advantages, including faster onset of action, greater potency, and reversibility of effects. Currently, the most advanced clinical trials are those with new oral inhibitors of P2Y12 receptors (terutroban), thrombin receptors (TRA SCH 530348) as well as thromboxanprostaglandin platelet receptors (prasugrel, AYD6140 and intravenous cangrelor). Contrary to highly effective intravenous GPIIbIIIa antagonists, the new oral GPIIbIIIa inhibitors (orbofiban, sibrafiban and xemilofiban) have not surpassed the efficacy and safety of classical antiplatelet agents used in the treatment of acute coronary syndromes.