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Advances in Hematology
Volume 2010 (2010), Article ID 595934, 7 pages
Review Article

Current Concepts on Antiplatelet Therapy: Focus on the Novel Thienopyridine and Non-Thienopyridine Agents

1Interventional Cardiology Department, St. Ambrogio Clinical Institute, 20149, Milan, Italy
2Institute of Cardiology, Ospedale “Le Molinette”, University of Turin, 10124, Turin, Italy
3Department of Cardiology, Arcispedale S. Anna, University of Ferrara, 44100, Ferrara, Italy
4Department of Cardiology, Royal North Shore Hospital, North Shore Heart Research Group, Kolling Institute, University of Sydney, Sydney NSW 2065, Australia

Received 23 March 2010; Accepted 16 August 2010

Academic Editor: David Varon

Copyright © 2010 L. Testa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Thienopyridines are a class of drug targeting the platelet adenosine diphosphate (ADP) 2 receptor. They significantly reduce platelet activity and are therefore clinically beneficial in settings where platelet activation is a key pathophysiological feature, particularly myocardial infarction. Ticlopidine, the first of the class introduced to clinical practice, was soon challenged and almost completely replaced by clopidogrel for its better tolerability. More recently, prasugrel and ticagrelor have been shown to provide a more powerful antiplatelet action compared to clopidogrel but at a cost of higher risk of bleeding complications. Cangrelor, a molecule very similar to ticagrelor, is currently being evaluated against clopidogrel. Considering the key balance of ischemic protection and bleeding risk, this paper discusses the background to the development of prasugrel, ticagrelor, and cangrelor and aims to characterise their risk-benefit profile and possible implementation in daily practice.