Vol. 7, Issue 2, Part D (2025)

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, with atherothrombosis as the central pathological mechanism driving coronary artery disease, ischemic stroke, and peripheral arterial disease ^[1]. Antiplatelet therapy is pivotal in preventing and treating these conditions by targeting platelet adhesion, activation, and aggregation ^[2]. Aspirin, the earliest and most widely used antiplatelet agent, irreversibly inhibits cyclooxygenase-1, thereby reducing thromboxane A2-mediated platelet activation; however, its benefits are often offset by gastrointestinal toxicity and bleeding risk ^[3]. The development of P2Y12 receptor inhibitors, such as clopidogrel, prasugrel, and ticagrelor, has revolutionized treatment, particularly in dual antiplatelet therapy (DAPT) following acute coronary syndromes and percutaneous coronary intervention ^[4]. Additional classes, including glycoprotein IIb/IIIa inhibitors, PAR-1 antagonists, and phosphodiesterase inhibitors, further broaden therapeutic options, though bleeding remains the major limitation ^[5]. Recent advances emphasize individualized therapy, incorporating genetic testing, platelet function assays, and escalation/de-escalation strategies to balance ischemic protection against hemorrhagic risk. Future perspectives focus on precision medicine, novel targets such as GPVI and PAR-4 receptors, and integration of digital health tools to optimize therapy. This review discusses the pathophysiology, treatment, current strategies, recent advances, and future directions in antiplatelet therapy for Cardiovascular diseases (CVDs) ^[6].