The antiplatelet
therapy with
aspirin and the
ADP-receptor blocker clopidogrel is currently the standard medication after coronary intervention or after
acute coronary syndrome to prevent recurrent ischemic events and reduce mortality. However, high interindividual response variability to antiplatelet treatment is described in up to 44% of treated patients. A poor response to
clopidogrel is caused by multifactorial mechanisms. Individual risk assessment including platelet function testing (PFT) can help to identify high risk patients, although recent randomized trials to investigate effects of PFT-guided
therapy have failed to detect an impact on prognostic outcome. Poor response to standard
antiplatelet agents can be overcome by switching to alternate substances.
Elinogrel is a novel competitive, reversible
ADP-receptor antagonist available in oral and intravenous formulation. Additional treatment with
elinogrel showed advantages over
clopidogrel, including more rapid, less variable, and more complete inhibition of platelet function without significantly increased
bleeding complications. This review gives an overview over the
investigational drug elinogrel for use in a personalized antiplatelet approach.