Antiplatelet Drugs in the Management of Coronary Artery Disease

Abstract Platelet adhesion, activation and aggregation play a pivotal role in the cascade of events leading to arterial thrombosis making antiplatelet therapy essential for the treatment of patients with coronary artery disease (CAD) manifestations. Dual antiplatelet therapy with aspirin and a P2Y 12 receptor inhibitor has represented for decades the cornerstone of treatment in patients with acute coronary syndromes (irrespective of management) or stable CAD undergoing percutaneous coronary intervention. However, advances in stent technology for the treatment of patients with CAD as well as developments in antithrombotic pharmacology have led to new insights in the management of these patients. A number of recently completed and ongoing trials have focused on minimizing the risk of bleeding complications while preserving efficacy with the use of antiplatelet agents. The present chapter focuses on the current guidelines as well as practical recommendations on antiplatelet treatment regimens for patients with CAD. In addition, emerging strategies that are the subject of ongoing investigations are also discussed.