Overview of pleiotropic effects of platelet P2Y12 receptor inhibitors

P Adamski; M Koziński; M Ostrowska; T Fabiszak; E P Navarese; P Paciorek; G Grześk; J Kubica

doi:10.1160/TH13-11-0915

Overview of pleiotropic effects of platelet P2Y12 receptor inhibitors

Thromb Haemost. 2014 Aug;112(2):224-42. doi: 10.1160/TH13-11-0915. Epub 2014 Apr 24.

Authors

P Adamski¹, M Koziński, M Ostrowska, T Fabiszak, E P Navarese, P Paciorek, G Grześk, J Kubica

Affiliation

¹ Piotr Adamski, MD, Department of Principles of Clinical Medicine, Collegium Medicum, Nicolaus Copernicus University, 9 Sklodowskiej-Curie Street, 85-094 Bydgoszcz, Poland, Tel.: +48 52 5854023, Fax: +48 52 5854024, E-mail: [email protected].

PMID: 24763899
DOI: 10.1160/TH13-11-0915

Abstract

Dual antiplatelet therapy consisting of one of the P2Y12 receptor inhibitors in conjunction with aspirin is the mainstay of treatment for patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary interventions (PCI). In recent years, multiple extra-platelet features of P2Y12 receptor antagonists have been reported in numerous clinical trials. The aim of this review is to summarise reported pleiotropic effects of clopidogrel, prasugrel, ticagrelor and other P2Y12 receptor blockers. We included observations made both in human and in animal models, together with proposed mechanisms of action for described features. If confirmed in randomised studies and properly applied to everyday practice, the observed extra-platelet actions could enable us to improve efficacy of ACS and post-PCI treatment, as well as to confine mortality and occurrence rate of cardiovascular events.

Keywords: Clopidogrel; P2Y12 receptor; off-target effect; prasugrel; ticagrelor.

Publication types

Review

MeSH terms

Adenosine / analogs & derivatives
Adenosine / metabolism
Adenosine / therapeutic use
Adenosine Monophosphate / analogs & derivatives
Adenosine Monophosphate / therapeutic use
Animals
Anti-Inflammatory Agents / therapeutic use
Anticarcinogenic Agents / therapeutic use
Clopidogrel
Drug Therapy, Combination
Humans
Off-Label Use
Piperazines / therapeutic use
Platelet Aggregation Inhibitors / adverse effects
Platelet Aggregation Inhibitors / therapeutic use*
Prasugrel Hydrochloride
Purinergic P2Y Receptor Antagonists / adverse effects
Purinergic P2Y Receptor Antagonists / therapeutic use*
Signal Transduction / drug effects
Thiophenes / therapeutic use
Ticagrelor
Ticlopidine / analogs & derivatives
Ticlopidine / therapeutic use
Treatment Outcome

Substances

Anti-Inflammatory Agents
Anticarcinogenic Agents
Piperazines
Platelet Aggregation Inhibitors
Purinergic P2Y Receptor Antagonists
Thiophenes
Adenosine Monophosphate
cangrelor
Clopidogrel
Prasugrel Hydrochloride
Ticagrelor
Adenosine
Ticlopidine