Utility of platelet adp receptor antagonism in the emergency department: a review☆

Abstract 

Emergency physicians are often the first clinicians to evaluate patients with acute atherothrombotic events. Platelet adenosine diphosphate (ADP) receptor antagonists, by specifically and irreversibly blocking ADP-induced platelet activation and aggregation, may reduce the injury associated with this process and can prevent recurrent ischemic events. Their role in the prevention of recurrent vascular events has been well documented. Recently, the CURE Trial showed that the combination of aspirin and clopidogrel improved outcomes in patients with non-ST-segment-elevation acute coronary syndrome (ACS). Familiarity with ADP receptor antagonists and knowledge about their appropriate use is important to the emergency physician in the management of ACS and potentially in that of transient ischemic attacks (TIAs), ischemic strokes, and acute peripheral arterial obstruction. This review addresses the pathophysiology of atherothrombosis and evaluates the potential use of ADP receptor antagonists in the Emergency Department setting.

Keywords:  ADP receptor antagonists, clopidogrel, acute coronary syndromes, TIA, Emergency Department, platelets, atherothrombosis, adenosine diphosphate