Abstract

BUITRAGO, Andrés F; GOMEZ, Mabel; SOTO, Mariana  and  DIAZ, Jesús H. New antiplatelet agents in acute coronary syndrome. Rev. Colomb. Cardiol. [online]. 2013, vol.20, n.3, pp.154-160. ISSN 0120-5633.

Currently, cardiovascular diseases are the leading cause of death in industrialized countries, and by 2020 they will be in developing countries. Acute coronary syndrome is characterized by the rupture or erosion of an atherosclerotic plaque that entails varying degrees of thrombosis and distal embolization, leading to a decrease in myocardial perfusion. Following vascular disruption begins a process of aggregation, platelet activation and adhesion starting the mural thrombus formation. As the first step in coronary thrombus formation involves activation and platelet aggregation, antiplatelet drug therapy is one of the cornerstones of acute coronary syndrome. The dual antiaggregation therapy with acetylsalicylic acid and a P2Y₁₂ receptor inhibitor are part of the current management of patients with acute coronary syndrome and of those undergoing percutaneous coronary intervention. Clopidogrel is the most used P2Y₁₂ receptor inhibitor, but its clinical benefits are limited by several factors that interfere with the conversion of the drug to its active metabolite. This is why new P2Y₁₂ receptor inhibitors such as prasugrel and ticagrelor, with more potent antiplatelet effect and greater clinical benefits have been recently developed. Recent updates of the management guidelines based on the evidence have included them as part of the treatment of this pathology with a degree of recommendation even greater than that of clopidogrel.

Keywords : coronary syndrome; acute myocardial infarction; evidence-based medicine.

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