Platelet ADP-receptor antagonists for cardiovascular disease: past, present and future

Aspirin can effectively prevent arterial thrombosis; however, its efficacy is limited as it inhibits the synthesis of only one platelet agonist (thromboxane A2). Here Raju and colleagues review agents that target ADP-mediated platelet activation. They examine controversies and unresolved issues associated with clopidogrel—the optimum loading dose, duration of treatment and incomplete platelet inhibition—and the new ADP-receptor antagonists prasugrel, AZD6140 and cangrelor, and explore their potential relative to each other and to clopidogrel.