Platelet physiology and pharmacology—relevant considerations for patient care

Abstract Platelets have an important role in the formation of hemostatic thrombi that develop at the site of vascular injury. However, pathologic activation of platelets can lead to obstructive thrombi resulting in clinical manifestations such as acute myocardial infarction, stroke, and acute limb ischemia. Therefore antiplatelet therapy has a key role in the treatment of cardiovascular disease manifestations. However, antiplatelet agents are associated with an increased risk of bleeding. Thus the ideal antiplatelet agent should have an optimal balance between safety and efficacy. Most recent studies have suggested that alternative regimens without aspirin (defined as “aspirin free”) to be associated with a better safety profile while preserving efficacy. This chapter provides an overview on platelet physiology and its implications for the development and use of antiplatelet therapies in patients with atherothrombotic disease manifestations.