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doi:10.1378/chest.08-0672
(Chest. 2008; 133:199S-233)
© 2008 American College of Chest Physicians
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Antiplatelet Drugs*

American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)

Carlo Patrono, MD; Colin Baigent, MD; Jack Hirsh, MD, FCCP and Gerald Roth, MD

* From the Catholic University School of Medicine (Dr. Patrono), Rome, Italy; Clinical Trial Service Unit (Dr. Baigent), University of Oxford, Oxford, UK; Hamilton Civic Hospitals (Dr. Hirsh), Henderson Research Centre, Hamilton, ON, Canada; and Seattle VA Medical Center (Dr. Roth), Seattle, WA.

Correspondence to: Carlo Patrono, MD, Catholic University School of Medicine, Largo F. Vito 1, 00168 Rome, Italy; e-mail: carlo.patrono{at}rm.unicatt.it

This article about currently available antiplatelet drugs is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). It describes the mechanism of action, pharmacokinetics, and pharmacodynamics of aspirin, reversible cyclooxygenase inhibitors, thienopyridines, and integrin {alpha}IIbβ3 receptor antagonists. The relationships among dose, efficacy, and safety are thoroughly discussed, with a mechanistic overview of randomized clinical trials. The article does not provide specific management recommendations; however, it does highlight important practical aspects related to antiplatelet therapy, including the optimal dose of aspirin, the variable balance of benefits and hazards in different clinical settings, and the issue of interindividual variability in response to antiplatelet drugs.

Key Words: abciximab • antiplatelet drugs • aspirin • clopidogrel • dipyridamole • eptifibatide • platelet pharmacology • resistance • ticlopidine • tirofiban






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