THE SUCCESS OF DIFFERENT APPROACHES TO THE DEVELOPMENT TO ANTIPLATELET DRUGS

The aim of this research is to precisely discuss and appraise the success of different approaches to the development to antiplatelet drugs. Platelets play a main function in haemostasis and the development of arterial thrombosis that is the final event complicating cardiovascular diseases and peripheral vascular diseases, and antiplatelet drugs improve survival of patients with these diseases. Antiplatelet drugs are aimed to avert and/or reverse platelets aggregation in arterial thrombosis, most significantly in myocardial infarction (MI), ischaemic stroke, and peripheral artery disease. The current therapeutic strategies aimed at inhibiting platelet aggregation: inhibition of cyclooxygenase, such as aspirin; inhibition of phosphodiesterases III and V and adenosine uptake by red blood cells, such as dipyridamole and cilostazol; inhibition of the platelet  adenosine diphosphate (ADP) P2Y12 receptor, such as ticlopidine and clopidogrel; inhibition of glycoprotein IIb/IIIa receptors that prevent fibrinogen binding, such as abciximab; and increasing nitric oxide level, such as triflusal. A range of new drugs are currently in different phases of clinical trials, including reloading of clopidogrel, the improvement of drug efficacy, thrombin receptor inhibition, thromboxane receptor inhibition, oral glycoprotein IIb/IIIa inhibition, phosphodiesterases inhibitors, and signalling pathways inhibition are revolution in the development of antiplatelet drugs. A greater understanding of a patient response can improve the efficacy and safety of antiplatelet therapy. This can be achieved by drug dose adjustment based on functional testing, by changing drugs combination, or by developing more potent and safer drugs.