Grand Rounds at The Johns Hopkins Bayview Medical
Center Section Editors: David B. Hellmann, MD, Charles Weiner, MD,
Stephen D. Sisson, MD, The Johns Hopkins Hospital, Baltimore, Md; David S.
Cooper, MD, Contributing Editor, JAMA .
Author Affiliation: Coronary Care Unit, The
Johns Hopkins Hospital, Baltimore, Md.
Acute coronary syndromes are a frequent cause of hospital admission
for patients with coronary artery disease. The pathophysiology of acute coronary
syndromes often involves plaque rupture or fissure with platelet aggregation.
Recognition of the importance of platelet aggregation resulted in several
large randomized trials testing 3 types of platelet antagonists, aspirin,
glycoprotein IIb/IIIa inhibitors, and adenosine diphosphate inhibitors. A
thorough understanding of the data, risks, and benefits of these therapies
is important to optimize treatment of the patient with an acute coronary syndrome.
Recognition that there is a great deal of interpatient variability in response
to these antiplatelet therapies highlights the need for future research in
Schulman SP. Antiplatelet Therapy in Non–ST-Segment Elevation Acute Coronary Syndromes. JAMA. 2004;292(15):1875-1882. doi:10.1001/jama.292.15.1875