Novel Strategies in Anti-Platelet Treatment for Coronary Artery Disease

Treatment with oral anti-platelet agents constitutes a cornerstone in the therapy of coronary artery disease. Coronary angioplasty and stent implantation improved the therapy of coronary artery disease and especially the treatment of acute myocardial infarction. Implementation of glycoprotein IIb/IIIa inhibition further advanced anti-platelet therapy as a central component in the treatment of acute coronary syndromes. Sustained prevention of reocclusion was achieved when dual anti-platelet therapy had been introduced and reduced the risk of stent thrombosis to ~1% following elective stenting in stable coronary artery disease. However, targeting more complex lesions or performing the intervention in states of increased platelet reactivity such as in acute coronary syndromes or in diabetic patients is still associated with a higher risk of stent thrombosis. Additionally, incomplete ADPreceptor inhibition by thienopyridine treatment contributes to increased cardiovascular events and mortality after coronary