Antiplatelet effects of prostacyclin analogues: Which one to choose in case of thrombosis or bleeding?

Cardiol J. 2021;28(6):954-961. doi: 10.5603/CJ.a2020.0164. Epub 2020 Nov 17.


Prostacyclin and analogues are successfully used in the treatment of pulmonary arterial hypertension (PAH) due to their vasodilatory effect on pulmonary arteries. Besides vasodilatory effect, prostacyclin analogues inhibit platelets, but their antiplatelet effect is not thoroughly established. The antiplatelet effect of prostacyclin analogues may be beneficial in case of increased risk of thromboembolic events, or undesirable in case of increased risk of bleeding. Since prostacyclin and analogues differ regarding their potency and form of administration, they might also inhibit platelets to a different extent. This review summarizes the recent evidence on the antiplatelet effects of prostacyclin and analogue in the treatment of PAH, this is important to consider when choosing the optimal treatment regimen in tailoring to an individual patients' needs.

Keywords: antiplatelet effect; bleeding; platelets; prostacyclin analogues; pulmonary arterial hypertension; thrombosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Epoprostenol / adverse effects
  • Hemorrhage / chemically induced
  • Humans
  • Hypertension, Pulmonary*
  • Pulmonary Artery
  • Thrombosis*


  • Epoprostenol