| Popis: |
Initially considered circulating cell fragments, the blood platelet is now recognized to play vital roles in both hemostasis and thrombosis. Recognition of its role in arterial thrombosis has, in part, been driven by the study of the effects of platelet inhibitory drugs on thrombus formation. There are many platelet inhibitory (antiplatelet) compounds described in the literature, with a wide range of mechanisms that mediate the platelet inhibitory effects. In order to cover current antiplatelet therapy in more detail, this review will deal primarily with currently available and commonly used antiplatelet agents that have regulatory approval. This will limit the review to the most widely used inhibitors, aspirin (a cyclo-oxygenase inhibitor), dipyridamole (a phosphodiesterase inhibitor), ticlopidine (an ADP antagonist) and the relatively recently introduced agent abciximab (a glycoprotein Ilb/IIIa inhibitor). Given the novelty of abciximab, a substantial portion of this chapter will review the preclinical and clinical development of this monoclonal antibody as antiplatelet therapy for the treatment of ischemic complications associated with percutaneous coronary revascularization. A brief description of investigational agents that are in late stage clinical evaluation is also included. |
