chapter  14
10 Pages


WithThomas P Carrigan, Deepak L Bhatt

Introduction The discovery that platelets are significant mediators of arterial thrombosis has led to the development of drugs to treat and prevent thrombosis, such as aspirin and clopidogrel. Both are used in the management of thrombotic events, particularly in the setting of acute coronary syndromes (ACS) and in the prevention of acute stent thrombosis following percutaneous interventions. Clopidogrel's mechanism of action is through the P2Y 12 receptor, preventing adenosine diphosphate (ADP) mediated platelet aggregation. However, the effect is delayed by several hours and the inhibition is irreversible. Cangrelor, on the other hand, is a new intravenous agent that rapidly and reversibly inhibits the P2Y 12 receptor, potentially ushering in a new, more flexible era in the management of acute thrombotic events. The use of cangrelor has been studied in several animal models and initial human trials. Here we present these reports and ongoing phase III trials currently in enrollment.