Overview of pleiotropic effects of platelet P2Y12 receptor inhibitors

Piotr Adamski; Marek Koziński; Małgorzata Ostrowska; Tomasz Fabiszak; Eliano Pio Navarese; Przemysław Paciorek; Grzegorz Grześk; Jacek Kubica

doi:10.1160/TH13-11-0915

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2014; 112(02): 224-242
DOI: 10.1160/TH13-11-0915

Review Article

Schattauer GmbH

Overview of pleiotropic effects of platelet P2Y12 receptor inhibitors

Authors

Piotr Adamski

¹Department of Principles of Clinical Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Marek Koziński

¹Department of Principles of Clinical Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Małgorzata Ostrowska

¹Department of Principles of Clinical Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Tomasz Fabiszak

²Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Eliano Pio Navarese

²Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Przemysław Paciorek

³Department of Emergency Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Grzegorz Grześk

²Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

⁴Department of Pharmacology and Therapy, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Jacek Kubica

²Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

Abstract

Summary

Dual antiplatelet therapy consisting of one of the P2Y12 receptor inhibitors in conjunction with aspirin is the mainstay of treatment for patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary interventions (PCI). In recent years, multiple extra-platelet features of P2Y12 receptor antagonists have been reported in numerous clinical trials. The aim of this review is to summarise reported pleiotropic effects of clopidogrel, prasugrel, ticagrelor and other P2Y12 receptor blockers. We included observations made both in human and in animal models, together with proposed mechanisms of action for described features. If confirmed in randomised studies and properly applied to everyday practice, the observed extra-platelet actions could enable us to improve efficacy of ACS and post-PCI treatment, as well as to confine mortality and occurrence rate of cardiovascular events.

Keywords

Clopidogrel - off-target effect - P2Y12 receptor - prasugrel - ticagrelor

Full Text

References

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