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Clopidogrel and the Newer P2Y12 Antiplatelet Agents - Pharmacology, Clinical Uses, and Adverse Effects (Hardcover)
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Clopidogrel and the Newer P2Y12 Antiplatelet Agents - Pharmacology, Clinical Uses, and Adverse Effects (Hardcover)
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Cardiovascular disease remains the leading cause of death in the
developed world. By preventing thromboembolic events such as heart
attacks and strokes, antiplatelet drugs have become a cornerstone
in the treatment of cardiovascular disease. Clopidogrel is a member
of the thienopyridine family which inhibit ADP-induced platelet
activation by irreversibly binding to the P2Y12 receptor.
Clopidogrel is one of the most commonly used medications with over
9 million prescriptions written annually. It is utilized in the
treatment of a wide variety of cardiovascular disorders including
acute coronary syndromes (ACS), percutaneous coronary intervention
(PCI) with stents, cerebrovascular disease, peripheral vascular
disease, and structural heart interventions. Most often,
clopidogrel is used in combination with low dose aspirin, providing
dual antiplatelet therapy (DAPT). Newer, more potent P2Y12
inhibitors, prasugrel and ticagrelor, are now available as
alternatives to clopidogrel. These newer agents have been shown to
be more effective than clopidogrel in reducing ischemic events in
patients with ACS. Recently a novel intravenous P2Y12 inhibitor,
cangrelor, has become available for use during PCI in patients who
have not been pretreated with an oral P2Y12 inhibitor. This book
examines virtually all aspects of P2Y12 inhibitors pharmacology,
clinical uses, randomized trial results, guideline recommendations,
and adverse drug effects. Important fundamental issues are reviewed
including comparative pharmacology of P2Y12 inhibitors, randomized
trials of clopidogrel in patients with coronary artery disease,
DAPT duration after PCI, and role of platelet function testing. The
newer P2Y12 inhibitors (prasugrel, ticagrelor, and cangrelor)
receive special focus. Use of antiplatelet therapy in specific
patient populations is discussed including patients with coronary
bypass graft surgery, peripheral vascular disease, cerebrovascular
disease, and structural heart disease. Management of antiplatelet
therapy in patients who require anticoagulation is a particularly
challenging clinical setting and is the topic of a featured review.
Finally, adverse drug effects and reactions are examined in a
section highlighting clopidogrel resistance, clopidogrel
hypersensitivity, and bleeding complications. This book is designed
to provide a comprehensive review of clopidogrel and the newer
P2Y12 inhibitors. Towards that end, the authors have enlisted an
internationally renowned group of experts as contributors. It is
intended to be a resource for clinicians, scientists,
pharmacologists, and all healthcare professionals involved in the
management of cardiovascular disease.
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