Platelet inhibition in percutaneous coronary interventions

Mechanical disruption of atherosclerotic plaques at the time of percutaneous coronary intervention (PCI) is a potent stimulus for arterial thrombosis. Since platelets play a crucial role in the cascade of clot formation, platelet inhibition is an essential step for successful PCI. Aspirin remains the cornerstone of any antithrombotic regimen in the interventional setting. The addition of a thienopyridine is mandatory following stenting to prevent thrombosis of the device. Whenever possible, patients undergoing PCI should be pretreated with clopidogrel and the drug should be continued for up to 1 year. Glycoprotein IIb/IIIa antagonists should be administered in high-risk patients, such as those with acute coronary syndromes, diabetes, or complex coronary anatomy.