A new era for antiplatelet therapy in patients with acute coronary syndrome

Abstract

Platelet aggregation is one of the most important underlying mechanisms in acute coronary syndromes (ACS). Antiplatelet therapy is considered as a cornerstone therapy and is widely used in these patients. Clopidogrel is currently a class I indication in patients with ACS. However, different degrees of resistance to clopidogrel have been the subject of many recent studies that led to higher dosing regimens of clopidogrel. Failure of clopidogrel to provide consistent platelet aggregation inhibition in all patients made the emergence of new more reliable agents crucial. Prasugrel and ticagrelor are the 2 new antiplatelet agents that have recently been compared with clopidogrel in patients with ACS. This article reviews the current evidence that supports the use of each of those agents and provides clinicians with an objective summary supporting their use.