Clopidogrel, prasugrel, or ticagrelor? a practical guide to use of antiplatelet agents in patients with acute coronary syndromes

Postgrad Med. 2013 Jul;125(4):91-102. doi: 10.3810/pgm.2013.07.2682.

Abstract

Aspirin is a cornerstone of therapy in the treatment of patients with acute coronary syndromes (ACS). However, dual antiplatelet therapy reduces the risk of stent thrombosis and cardiovascular events compared with aspirin alone in the treatment of patients with ACS. Recently, there has been debate as to which antiplatelet agent should be added to aspirin in the ACS treatment regimen. This review summarizes the pharmacologic and clinical data comparing clopidogrel, prasugrel, and ticagrelor, and provides a practical guide to clinicians for determining which antiplatelet to use for patients with ACS.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / drug therapy*
  • Adenosine / analogs & derivatives*
  • Adenosine / pharmacology
  • Adenosine / therapeutic use
  • Aspirin / therapeutic use*
  • Clopidogrel
  • Decision Support Techniques
  • Drug Therapy, Combination
  • Humans
  • Induction Chemotherapy
  • Maintenance Chemotherapy
  • Piperazines / pharmacology
  • Piperazines / therapeutic use*
  • Platelet Aggregation / drug effects
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Practice Guidelines as Topic
  • Prasugrel Hydrochloride
  • Thiophenes / pharmacology
  • Thiophenes / therapeutic use*
  • Ticagrelor
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / pharmacology
  • Ticlopidine / therapeutic use

Substances

  • Piperazines
  • Platelet Aggregation Inhibitors
  • Thiophenes
  • Clopidogrel
  • Prasugrel Hydrochloride
  • Ticagrelor
  • Adenosine
  • Ticlopidine
  • Aspirin