I. Mechanism of Action
II. Indications
III. Available Antiplatelet Agents

GLOSSARY
acute coronary syndrome this syndrome defines patients with acute chest pain caused by myocardial infarction or unstable angina.
aggregation platelet clumping.
angina chest pain caused by temporary lack of blood to an area of heart muscle cells, usually caused by severe obstruction of the artery supplying blood to the segment of cells.
arrhythmia general term for an irregularity or rapidity of the heartbeat, an abnormal heart rhythm.
atherosclerosis same as atheroma; raised plaques filled with cholesterol, calcium, and other substances on the inner wall of arteries that obstruct the lumen and flow of blood; the plaque of atheroma hardens the artery, hence the term atherosclerosis (sclerosis ¼ hardening).
myocardial infarction death of an area of heart muscle due to blockage of a coronary artery by blood clot and atheroma, medical term for heart attack or coronary thrombosis.
PCI percutaneous coronary intervention; percutaneous trans-luminal coronary angioplasty (PTCA), often involving the use of intracoronary stents.
platelets very small disk-like particles that circulate in the blood alongside red and white blood cells initiating the formation of blood clots; platelets clump and form little plugs called platelet aggregation, thus causing bleeding to stop.

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• I. MECHANISM OF ACTION
  Coronary thrombosis is known to be the major cause of coronary artery occlusion resulting in fatal or nonfatal acute myocardial infarction. Antiplatelet agents are named this because they inhibit platelet aggregation, which plays a major role in coronary thrombosis, myo-cardial infarction, and cardiac death.
• II. INDICATIONS
  Antiplatelet agents are of proven value in the manage¬ment of non-ST segment elevation myocardial infarction; stable and unstable angina; post coronary artery bypass graft (CABG), coronary artery stents, cerebral transient ischemic attacks (TIAs); and lone atrial fibrillation in individuals younger than 65.
• III. AVAILABLE ANTIPLATELET AGENTS
  Currently used antiplatelet agents include aspirin, clo-pidogrel (ticlopidine still has a role, see Section III.B), dipyridamole plus aspirin, and platelet glycoprotein IIb/IIIa receptor blockers.
• BIBLIOGRAPHY
  Cannon, C. Small molecule glycoprotein IIb/IIIa receptor inhibitors as upstream therapy in acute coronary syndromes. Insights from the TACTICS TIMI-18 Trial. J. Am. Coll. Cardiol., 41:43–48S, 2003.

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