Table 1. Available antiplatelet... | American Society of Hematology

Table 1.

Available antiplatelet therapies

Mechanism	Agent	Structure	Route/dosing	Clinical use
COX-1 inhibition	Aspirin	Acetylsalicylic acid	Oral/daily	Coronary artery disease, cerebrovascular disease, PAD, primary prevention, stents, CABG, CEA
Irreversible P2Y₁₂ antagonism	Ticlopidine	Thienopyridine	Oral/twice daily	Cerebrovascular disease, coronary stents (now rarely used)
	Clopidogrel	Thienopyridine	Oral/daily	Prior myocardial infarction, ischemic stroke, or symptomatic PAD, as monotherapy; ACS or coronary stenting, as part of dual antiplatelet therapy with aspirin
	Prasugrel	Thienopyridine	Oral/daily	Patients with ACS treated with stents, as part of dual antiplatelet therapy with aspirin
Reversible P2Y₁₂ antagonism	Ticagrelor	Cyclopentyl-triazolo-pyrimidine	Oral/twice daily	Patients with ACS, as part of dual antiplatelet therapy with aspirin
	Cangrelor	ATP analog	IV	PCI when not pretreated with oral P2Y₁₂ antagonist
GPIIb-IIIa inhibition	Abciximab	Murine human chimeric F_ab fragment	IV	PCI
	Eptifibatide	KGD-containing cyclic heptapeptide	IV	ACS, PCI
	Tirofiban	Nonpeptide mimetic based on RGD	IV	ACS, PCI
PAR1 inhibition	Vorapaxar	Tricyclic himbacine derivative	Oral/daily	Prior myocardial infarction, PAD
PDE Inhibition	Cilostazol	2-Oxoquinoline derivative	Oral/twice daily	PAD
	Dipyridamole	Pyrimidopyridine derivative	Oral/twice daily	Stroke or TIA when used with aspirin
Combination	Aspirin/dipyridamole (Aggrenox)	Acetylsalicylic acid/pyrimidopyridine derivative	Oral/twice daily	Stroke, TIA

Mechanism	Agent	Structure	Route/dosing	Clinical use
COX-1 inhibition	Aspirin	Acetylsalicylic acid	Oral/daily	Coronary artery disease, cerebrovascular disease, PAD, primary prevention, stents, CABG, CEA
Irreversible P2Y₁₂ antagonism	Ticlopidine	Thienopyridine	Oral/twice daily	Cerebrovascular disease, coronary stents (now rarely used)
	Clopidogrel	Thienopyridine	Oral/daily	Prior myocardial infarction, ischemic stroke, or symptomatic PAD, as monotherapy; ACS or coronary stenting, as part of dual antiplatelet therapy with aspirin
	Prasugrel	Thienopyridine	Oral/daily	Patients with ACS treated with stents, as part of dual antiplatelet therapy with aspirin
Reversible P2Y₁₂ antagonism	Ticagrelor	Cyclopentyl-triazolo-pyrimidine	Oral/twice daily	Patients with ACS, as part of dual antiplatelet therapy with aspirin
	Cangrelor	ATP analog	IV	PCI when not pretreated with oral P2Y₁₂ antagonist
GPIIb-IIIa inhibition	Abciximab	Murine human chimeric F_ab fragment	IV	PCI
	Eptifibatide	KGD-containing cyclic heptapeptide	IV	ACS, PCI
	Tirofiban	Nonpeptide mimetic based on RGD	IV	ACS, PCI
PAR1 inhibition	Vorapaxar	Tricyclic himbacine derivative	Oral/daily	Prior myocardial infarction, PAD
PDE Inhibition	Cilostazol	2-Oxoquinoline derivative	Oral/twice daily	PAD
	Dipyridamole	Pyrimidopyridine derivative	Oral/twice daily	Stroke or TIA when used with aspirin
Combination	Aspirin/dipyridamole (Aggrenox)	Acetylsalicylic acid/pyrimidopyridine derivative	Oral/twice daily	Stroke, TIA

CABG, coronary artery bypass graft; CEA, carotid endarterectomy; KGD, Lys-Gly-Asp; PAD, peripheral artery disease; PDE, phosphodiesterase; RGD, Arg-Gly-Asp; TIA, transient ischemic attack.