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Platelet Inhibition as a Therapeutic Approach in Intravascular Intervention

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Platelets, Haemostasis and Inflammation

Part of the book series: Cardiac and Vascular Biology ((Abbreviated title: Card. vasc. biol.,volume 5))

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Abstract

Platelets are the primary mediators of vascular haemostasis. They express numerous adhesion receptors on their surface enabling a direct interaction with the endothelial cells of the blood vessel wall and the underlying extracellular matrix. In addition they interact with leucocytes and fulfil functions of innate immunity. Furthermore they contain a plethora of stored proteins in intracellular granula, including cytokines, which are released upon activation. Platelets undergo a rapid and extreme change of their surface membrane once they are activated. Platelet activation can occur via soluble platelet activators (e.g. thrombin and ADP) or by direct interaction of platelet adhesion receptors with components of the vessel wall.

Besides naturally occurring platelet activators, medical devices used for intravascular interventions do represent surfaces that may directly or indirectly lead to platelet activation and subsequent platelet aggregation ultimately causing intravascular thrombosis and thereby clinical adverse events. For many decades, aspirin was the mainstay of platelet inhibition. Within the last two decades, a rapidly evolving era of extensive research on platelets and atherothrombosis led to the clinical development of several novel antiplatelet agents that successfully entered daily clinical practice in intravascular interventions. In addition to aspirin, currently clinically approved antiplatelet agents used in intravascular interventions target the platelet P2Y12 receptor, the platelet PAR1 receptor and the platelet fibrinogen receptor (GPIIb/IIIa).

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Authors and Affiliations

  1. Cardiology and Angiology I, Heart Center, University of Freiburg, Freiburg, Germany

    Ingo Ahrens

  2. Departement of Cardiology and Medical Intensive Care, Augustinerinnen Hospital, Cologne, Academic Teaching Hospital University of Cologne, Jakobstr. 27-31, 50678, Cologne, Germany

    Ingo Ahrens

  3. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain

    Hector Bueno

  4. Departamento de Cardiología, Instituto de Investigación I+12, Hospital Universitario 12 de Octubre, Madrid, Spain

    Hector Bueno

  5. Universidad Complutense de Madrid, Madrid, Spain

    Hector Bueno

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  1. Ingo Ahrens
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  2. Hector Bueno
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Correspondence to Ingo Ahrens .

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Editors and Affiliations

  1. Cardiology and Angiology I, University-Heart Center Freiburg, Freiburg, Germany

    Andreas Zirlik

  2. Cardiology and Angiology I, University-Heart Center Freiburg, Freiburg, Germany

    Christoph Bode

  3. Department of Cardiology, University Hospital Tübingen, Tübingen, Germany

    Meinrad Gawaz

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  • Conflict of Interest: Ingo Ahrens and Hector Bueno declares that they have no conflict of interest.

  • Ethical Approval: This article does not contain any studies with human participants or animals performed by any of the authors.

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Ahrens, I., Bueno, H. (2017). Platelet Inhibition as a Therapeutic Approach in Intravascular Intervention. In: Zirlik, A., Bode, C., Gawaz, M. (eds) Platelets, Haemostasis and Inflammation. Cardiac and Vascular Biology, vol 5. Springer, Cham. https://doi.org/10.1007/978-3-319-66224-4_6

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