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Vorapaxar

An oral competitive PAR-1 antagonist that inhibits thrombin induced platelet aggregation.

Use in acute coronary syndromes without ST-segment elevation and 82 standard dual antiplatelet therapy resulted in fewer myocardial infarctions (Becker RC et al, Goto S et al).

In a multinational, double-blind, randomized trial comparing this agent with placebo in 12,944 patients with acute coronary syndrome without ST-segment elevation: the addition of this agent to standard therapy did not reduce endpoints of myocardial infarction, stroke, recurrent ischemia, or urgent coronary revascularization, but did significantly increased the risk of major bleeding, including intracranial hemorrhage (Investigators in the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER).

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