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Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar

This article reviews the pharmacology, clinical efficacy, and safety of vorapaxar in reducing cardiovascular risk. Vorapaxar is a tricyclic himbacine-derived reversible inhibitor of platelet surface protease activator receptor-1, which prevents thrombin from activating platelets. Two Phase III clini...

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Autor principal: Cheng, Judy WM
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913541/
https://www.ncbi.nlm.nih.gov/pubmed/27366081
http://dx.doi.org/10.2147/VHRM.S81342
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author Cheng, Judy WM
author_facet Cheng, Judy WM
author_sort Cheng, Judy WM
collection PubMed
description This article reviews the pharmacology, clinical efficacy, and safety of vorapaxar in reducing cardiovascular risk. Vorapaxar is a tricyclic himbacine-derived reversible inhibitor of platelet surface protease activator receptor-1, which prevents thrombin from activating platelets. Two Phase III clinical trials and multiple subanalyses from the two trials with vorapaxar have been published. In patients with recent acute coronary syndrome, vorapaxar, when added to standard therapy, did not reduce the composite cardiovascular end point. In contrary, in a study of secondary prevention for patients with cardiovascular diseases, vorapaxar reduced the risk of cardiovascular death or ischemic events (myocardial infarction, stroke) in patients with stable atherosclerosis who were receiving standard therapy. Vorapaxar is approved in the US for use with aspirin and/or clopidogrel in the secondary prevention of thrombogenic cardiovascular events in stable patients with peripheral arterial disease or a history of myocardial infarction. Vorapaxar increases risk of bleeding and is contraindicated in patients with previous cerebrovascular events. It is essential to balance individual patient’s bleeding risk to any further cardiovascular benefits that they may get. Future investigation is also needed to evaluate use of vorapaxar with newer antiplatelet agents such as ticagrelor and cangrelor, as well as its role as monotherapy.
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spelling pubmed-49135412016-06-30 Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar Cheng, Judy WM Vasc Health Risk Manag Review This article reviews the pharmacology, clinical efficacy, and safety of vorapaxar in reducing cardiovascular risk. Vorapaxar is a tricyclic himbacine-derived reversible inhibitor of platelet surface protease activator receptor-1, which prevents thrombin from activating platelets. Two Phase III clinical trials and multiple subanalyses from the two trials with vorapaxar have been published. In patients with recent acute coronary syndrome, vorapaxar, when added to standard therapy, did not reduce the composite cardiovascular end point. In contrary, in a study of secondary prevention for patients with cardiovascular diseases, vorapaxar reduced the risk of cardiovascular death or ischemic events (myocardial infarction, stroke) in patients with stable atherosclerosis who were receiving standard therapy. Vorapaxar is approved in the US for use with aspirin and/or clopidogrel in the secondary prevention of thrombogenic cardiovascular events in stable patients with peripheral arterial disease or a history of myocardial infarction. Vorapaxar increases risk of bleeding and is contraindicated in patients with previous cerebrovascular events. It is essential to balance individual patient’s bleeding risk to any further cardiovascular benefits that they may get. Future investigation is also needed to evaluate use of vorapaxar with newer antiplatelet agents such as ticagrelor and cangrelor, as well as its role as monotherapy. Dove Medical Press 2016-06-14 /pmc/articles/PMC4913541/ /pubmed/27366081 http://dx.doi.org/10.2147/VHRM.S81342 Text en © 2016 Cheng. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Cheng, Judy WM
Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
title Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
title_full Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
title_fullStr Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
title_full_unstemmed Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
title_short Impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
title_sort impact of selective platelet inhibition in reducing cardiovascular risk – role of vorapaxar
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913541/
https://www.ncbi.nlm.nih.gov/pubmed/27366081
http://dx.doi.org/10.2147/VHRM.S81342
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