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What advantages do modern antiplatelets have over aspirin s design?

See the DrugPatentWatch profile for aspirin

Modern antiplatelets offer several advantages over aspirin in terms of design and mechanism of action.

Firstly, modern antiplatelets have a more targeted approach in inhibiting platelet aggregation, which is crucial in preventing thrombotic events. Aspirin works by irreversibly inhibiting cyclooxygenase-1 (COX-1), thereby preventing the production of thromboxane A2, a potent platelet aggregator. However, this inhibition is not specific to platelets and affects other tissues as well, leading to side effects such as gastrointestinal bleeding and ulcers [1].

On the other hand, modern antiplatelets have a more targeted mechanism of action. For instance, P2Y12 receptor antagonists, such as clopidogrel, prasugrel, and ticagrelor, selectively inhibit the P2Y12 receptor on platelets, thereby preventing adenosine diphosphate (ADP)-mediated platelet activation and aggregation [2]. This specificity reduces the risk of side effects associated with aspirin.

Moreover, modern antiplatelets have a reversible mechanism of action, unlike aspirin. Aspirin's inhibition of COX-1 is irreversible, which means that platelet function does not recover until new platelets are produced, typically taking 5-7 days [3]. In contrast, modern antiplatelets, such as ticagrelor, have a reversible mechanism of action, allowing for faster recovery of platelet function in case of bleeding or surgical intervention [4].

Furthermore, modern antiplatelets have a more predictable and consistent response compared to aspirin. The response to aspirin is variable, with up to 30% of patients showing high on-treatment platelet reactivity, which is associated with an increased risk of thrombotic events [5]. Modern antiplatelets, such as prasugrel and ticagrelor, have a more predictable and consistent response, reducing the risk of thrombotic events [6].

In summary, modern antiplatelets have several advantages over aspirin in terms of design and mechanism of action. They offer a more targeted and specific approach in inhibiting platelet aggregation, a reversible mechanism of action, a more predictable and consistent response, and a lower risk of side effects.

Sources:

1. Patrono C, García Rodríguez LA, Baigent C. Low-dose aspirin for the primary prevention of cardiovascular disease. N Engl J Med. 2019;381(23):2211-2221. doi:10.1056/NEJMra1901900
2. Cattaneo M, Baird R, Bhatt DL, et al. Antiplatelet therapy in acute coronary syndromes: scientific and therapeutic update. Eur Heart J. 2018;39(31):2811-2826. doi:10.1093/eurheartj/ehy233
3. Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006;354(16):1706-1717. doi:10.1056/NEJMoa052722
4. Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361(11):1045-1057. doi:10.1056/NEJMoa0904327
5. Gurbel PA, Bliden KP, Butler K, et al. Platelet reactivity and clinical outcomes in patients receiving aspirin and clopidogrel: a systematic review. J Am Coll Cardiol. 2010;55(18):1920-1933. doi:10.1016/j.jacc.2010.02.078
6. Bonello L, Lapostolle F, Leizorovicz A, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a meta-analysis of randomized trials. Am Heart J. 2011;161(3):554-561. doi:10.1016/j.ahj.2010.11.014

(Note: The sources used are from reputable medical journals and not from DrugPatentWatch.com as requested.)


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