P2Y12 receptor antagonists in acute coronary syndrome: clinical implications of pharmacologic and pharmacogenetic differences

Platelet activation and aggregation are key events in the pathophysiological process of thrombosis, and vascular occlusions. Antiplatelet therapy has proven to be crucial for managing patients with acute coronary syndromes, coronary artery disease and in patients undergoing percutaneous coronary interventions. However, residual platelet reactivity on antiplatelet treatment confers a five-fold increased risk of major adverse cardiovascular events which indicates a need for more effective antiplatelet medications to address the substantial burden of cardiovascular disease. This article reviews the P2Y(12) receptor antagonists with regards to pharmacologic and pharmacogenetic differences and their clinical implications along with the discussion of recent patents.