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

Judy WM Cheng Department of Pharmacy Practice, MCPHS University, Boston, MA, USA Abstract: 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 a...

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Main Author: Cheng JWM
Format: Article
Language:English
Published: Dove Medical Press 2016-06-01
Series:Vascular Health and Risk Management
Subjects:
Online Access:https://www.dovepress.com/impact-of-selective-platelet-inhibition-in-reducing-cardiovascular-ris-peer-reviewed-article-VHRM
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author Cheng JWM
author_facet Cheng JWM
author_sort Cheng JWM
collection DOAJ
description Judy WM Cheng Department of Pharmacy Practice, MCPHS University, Boston, MA, USA Abstract: 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. Keywords: vorapaxar, protease activator receptor-1 antagonist, atherosclerotic disease
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spelling doaj.art-ddb13e697f2343a3a8424bfcc93714352022-12-22T00:54:05ZengDove Medical PressVascular Health and Risk Management1178-20482016-06-012016Issue 126326827427Impact of selective platelet inhibition in reducing cardiovascular risk - role of vorapaxarCheng JWMJudy WM Cheng Department of Pharmacy Practice, MCPHS University, Boston, MA, USA Abstract: 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. Keywords: vorapaxar, protease activator receptor-1 antagonist, atherosclerotic diseasehttps://www.dovepress.com/impact-of-selective-platelet-inhibition-in-reducing-cardiovascular-ris-peer-reviewed-article-VHRMVorapaxarprotease activator receptor – 1 antagonistatherosclerotic disease
spellingShingle Cheng JWM
Impact of selective platelet inhibition in reducing cardiovascular risk - role of vorapaxar
Vascular Health and Risk Management
Vorapaxar
protease activator receptor – 1 antagonist
atherosclerotic disease
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 Vorapaxar
protease activator receptor – 1 antagonist
atherosclerotic disease
url https://www.dovepress.com/impact-of-selective-platelet-inhibition-in-reducing-cardiovascular-ris-peer-reviewed-article-VHRM
work_keys_str_mv AT chengjwm impactofselectiveplateletinhibitioninreducingcardiovascularriskroleofvorapaxar