Which medications in the drug class Antiplatelet agents are used in the treatment of Acute Coronary Syndrome?

Updated: Sep 30, 2020
  • Author: David L Coven, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Antiplatelet agents

Antiplatelets inhibit the cyclooxygenase system, decreasing the level of thromboxane A2, which is a potent platelet activator. Antiplatelet therapy reduces mortality by reducing the risk of fatal strokes and fatal myocardial infarctions.

Aspirin (Anacin, Ascriptin, Bayer Aspirin)

Early administration of aspirin (eg, Anacin, Ascriptin, Bayer Aspirin) in patients with acute myocardial infarction may reduce cardiac mortality in the first month. The adult dose is 160-324 mg PO or chewed. It can be administered as a suppository if the patient is unable to take PO medications. Aspirin reduces morbidity and mortality and is continued indefinitely. If administered with ticagrelor (Brilinta), do not exceed 100 mg/day after a one-time loading dose of 325 mg.

Vorapaxar (Zontivity)

Vorapaxar reversibly inhibits protease-activated receptor 1 (PAR-1) which is expressed on platelets, but its long half-life makes it effectively irreversible. It is indicated to reduce thrombotic cardiovascular events in patients with a history of MI or with peripheral arterial disease. It is not used as monotherapy, but added to aspirin and/or clopidogrel.


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