Antiplatelet agents make a comeback in ST-elevation myocardial infarction

Although data from CLARITY-TIMI 28 and COMMIT/CCS-2 affirm the importance of antiplatelet agents as adjuncts to fibrinolytic therapy in STEMI, several questions remain. Novel antiplatelet agents have attractive properties for use in STEMI such as rapid onset, higher and more consistent levels of platelet inhibition, and in some cases rapid offset. Although lessons from the past suggest caution before embracing potent antiplatelet agents in STEMI, current data with clopidogrel coupled with potential pharmacologic advantages of newer agents may signal a bright future for adjunctive antiplatelet agents in STEMI.