Oral Antiplatelet Agents
The mainstay of antiplatelet therapy has been aspirin. Several large randomized trials have been performed to date and suggest that aspirin may be effective in both primary and secondary prevention of adverse cardiac events. However, these trials have varied in their particular populations and endpoints, preventing an absolute mandate for the use of aspirin based solely on scientific data.
Recently, newer oral antiplatelet agents have been developed as either alternatives to aspirin or as adjunctive therapy. These agents, clopidogrel and ticlopidine, have carved a niche in the prevention of subacute stent thrombosis and have highlighted the relatively weak antiplatelet activity of aspirin.
Finally, there has been great excitement generated by the oral glycoprotein IIb/IIIa receptor inhibitors. Many new oral IIb/IIIa agents are currently under study. At least two agents have been withdrawn because of excess bleeding or lack of efficacy suggesting that further work is needed to better define the appropriate dosing regimens for these promising agents.