New approaches of antiplatelet therapy in the prevention of cardiovascular diseases

Abstract

Cardiovascular diseases are considered to be the leading cause of mortality in the world.Modifiable and non modifiable risk factors with different mechanisms affect the endothelial cells and lead to development of endothelial dysfunction. Endothelial dysfunction as a cornerstone of cardiovascular diseases’ pathophysiological mechanisms, causes overactivation and over aggregation of platelets resulting in the development of ischemic complications.Though we have huge arsenal of antiplatelet and anticoagulant drugs used for prevention and treatment of ischemic consequences, there is an increase of annual cases of side effects associated with pharmacotherapy.The “gold standard” of antiplatelet therapy - Aspirin gradually loses its role and importance in the primary and secondary prevention, as well as at the treatment of cardiovascular diseases due to the haemorrhage mostly on those patients who are under 70, have diabetes or are in the low and mild risk group of cardiovascular disease.That is why the development of newer and safer substances with possible less hemorrhagic complications has become an important task of modern medicine.In this point of view the plant based agents, containing rich composition of polyphenolic substances, particularly anthocyanins and flavonoids, could serve as potent and promising sources due to their antiplatelet effects, which is conditioned with several action mechanisms.Each action mechanism of polyphenolic substances is directed to the different phases of platelet aggregation. In this paper we have discussed the mechanisms and side effects of antiplatelet drugs with proven activity, the plants as a source for developing new and safe antiplatelet dosage forms and the technological ways to develop optimal drug dosage forms.