Platelet aggregation inhibitors stroke

The main indications for aspirin as a platelet aggregation inhibitor are prevention of stroke in patients with cerebrovascular disease, prevention of myocardial infarct in patients with unstable angina or after myocardial infarction. For the prevention of myocardial infarction in someone with documented or suspected coronary artery disease, doses as low as 75 mg daily (or possibly even lower) are sufflcient. 

Methyl (R)-o-chloromandelate represents the key building block for the synthesis of clopidogrel, a platelet aggregation inhibitor widely administered to atherosclerotic patients with the risk of a heart attack or stroke that are caused by the formation of a clot in the blood. The worldwide sales of this pharmaceutical... 

Ticlopidine, a platelet aggregation inhibitor possessing antithrombotic effects (250 mg p.o. b.i.d.), is used to reduce the risk of thrombotic stroke in patients with a history of stroke or who have experienced stroke precursors (see also Figures 13 and 93). Ticlopidine, a thienopyridine derivative, and a new antiplatelet agent for secondary prevention of stroke, causes potent inhibition of adenosine diphosphate (ADP)-induced platelet aggregation and moderate inhibition... 

A variety of clinical states are associated with thrombosis. The present discussion is limited to a few of the more prominent thromboembolic diseases further Information on this subject may be found in several reviews.3,7-9 The most common clinical states which Involve clot-like, venous thrombi are deep vein thrombosis, particularly as a postsurgical complication, and pulmonary embolism. Anticoagulants such as heparin and the coumarins have been known for years to be effective in the prevention of these types of thrombi and more recent experience has demonstrated the efficacy of fibrinolytic agents such as streptokinase for their dissolution.3,9 Platelet aggregation Inhibitors have only recently been evaluated clinically in the prevention of venous thrombosis. These studies are crucial to the resolution of the controversy as to whether platelets play a vital role in the initiation of venous thrombi.10 There is persistent histological evidence that indicates venous thrombi begin as platelet aggregates.H Myocardial infarction and stroke are... 

Antagonists of the ADP P2Y, 2 receptor, ticlopidine and its safer successor clopidogrel, are also potent inhibitors of platelet aggregation and have demonstrated their efficacy alone and on top of ASA in numerous in clinical studies. The results of the CAPRIE study, a large study involving 19,185 patients with recent Ml, stroke, or established peripheral arterial disease (PAD) demonstrated an 8.7% overall risk reduction versus ASA in the combined endpoints of the first occurrence of Ml, stroke, or other vascular death (30). 

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