Vorapaxar in the treatment of cardiovascular diseases.

Udaya S Tantry, Kevin P Bliden, Rahul Chaudhary, Marko Novakovic, Amit Rout, Paul A Gurbel

Future cardiology 2020 Sep

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Vorapaxar specifically and effectively inhibits protease activated receptor-1 and may reduce thrombin-mediated ischemic events without interfering primary hemostasis. In the TRA-2P-TIMI 50 trial, vorapaxar reduced the risk of primary ischemic outcome but with increased bleeding risk. In the post hoc analysis, in patients with a history of myocardial infarction, peripheral artery disease, the net clinical outcome favored vorapaxar therapy with 10% reduction in cardiovascular death, myocardial infarction, stroke, urgent coronary revascularization and moderate or severe bleeding. Based on these favorable results, vorapaxar was approved for the reduction of thrombotic cardiovascular events in patients with prior myocardial infarction or with peripheral artery disease on top of standard antiplatelet therapy. A careful patient selection is needed to balance efficacy versus safety.

Citation

Udaya S Tantry, Kevin P Bliden, Rahul Chaudhary, Marko Novakovic, Amit Rout, Paul A Gurbel. Vorapaxar in the treatment of cardiovascular diseases. Future cardiology. 2020 Sep;16(5):373-384