Review Article

Role of the Platelets and Nitric Oxide Biotransformation in Ischemic Stroke: A Translative Review from Bench to Bedside

Table 1

Effect of different antiplatelet drug treatments on outcome in ischemic stroke.

Mechanism of actionPrimary prevention of ischemic strokeAcute phase of ischemic strokeSecondary prevention of ischemic stroke
Animal studiesHuman studiesAnimal studiesHuman studiesAnimal studiesHuman studies

Acetylsalicylic acidCyclooxygenase inhibitorBeneficial [182]Neutral (beneficial after artery stenting) [166]Beneficial [161]Beneficial in TIA and minor stroke () [183]Beneficial [184]Beneficial [154]
ClopidogrelInhibitor of P2Y12 receptorBeneficial [185]Neutral (beneficial after artery stenting) [166]Beneficial [186]Beneficial in TIA and minor stroke () [183]Beneficial [185]Beneficial [154]
PrasugrelInhibitor of P2Y12 receptorBeneficial [187]Neutral (beneficial after ACS) [188]Beneficial [186]Harmful [154]Beneficial [189]Harmful [190]
TicagrelorInhibitor of P2Y12 receptorBeneficial [191]Neutral (better prevention with higher hemorrhage incidence) [192]Beneficial [191]Harmful [154]No data foundNeutral (better prevention with higher hemorrhage incidence) [193]
CangrelorInhibitor of P2Y12 receptorNeutral [188]No data foundBeneficial [186]Harmful [154]No data foundBeneficial in stroke prevention in the perioperative period [194]
VorapaxarPAR-1 antagonistNo data foundHarmful [195]No data foundHarmful [169]No data foundHarmful/neutral [196, 197]
TirofibanGPIIb/IIIa blockerBeneficial (group effect) [198]No data found [199] (neutral/harmful in the second-generation GPIIb/IIIa blockers)Beneficial [172]Beneficial [157]Beneficial [198]Uncertain [200]
AbciximabGPIIb/IIIa blockerBeneficial (group effect) [198]No data found [199] (neutral/harmful in the second-generation GPIIb/IIIa blockers)Beneficial [201]Uncertain [154]Beneficial [198]Harmful [199]
EptifibatideGPIIb/IIIa blockerBeneficial (group effect) [198]No data found [199] (neutral/harmful in the second-generation GPIIb/IIIa blockers)Beneficial [201]Beneficial [151]Beneficial [198]Uncertain [200]
AnfibatideGPIb blockerBeneficial [202]No data foundBeneficial [172]No data foundNo data foundNo data found
CaplacizumabAnti-vWF antibody, blocker of platelet GPI-vWF adhesionBeneficial [173]No data foundBeneficial [173]No data foundNo data foundNo data found
ADAMTS13Recombinant human enzyme transforming vWF to smaller, less active formsBeneficial [175]No data foundBeneficial [203]No data foundNo data foundNo data found
rHA-infestin-4XIIa inhibitorBeneficial [176]No data foundBeneficial [204]No data foundNo data foundNo data found
RevaceptCompetitive blocker of platelet GPVI adhesion to vWFBeneficial [177]Beneficial [205]Beneficial [206]No data available (ongoing study of patients with stable coronary artery disease undergoing elective PCI)No data foundNo data found
F-0401Dihydropyridine calcium antagonist with PAF antagonistic actionBeneficial [179]No data foundBeneficial [207]Beneficial (in the study of human astrocytoma and neuroblastoma cells) [207]No data foundNo data found
BN 50739PAF antagonistBeneficial [180]No data foundBeneficial [209]No data foundNo data foundNo data found
InclacumabP-selectin neutralizing antibodyNo data foundNo data foundNo data foundNo data available (beneficial in non-ST-segment elevation myocardial infarction) [181]No data foundNo data found