Optimización de la antiagregación en el infarto agudo de miocardio con elevación del segmento ST

Recent years have witnessed enormous changes in the use of antiplatelet therapy in ST-segment-elevation acute myocardial infarction. After more than a decade when the standard treatment for patients undergoing primary angioplasty or requiring fibrinolysis involved aspirin and clopidogrel, a new era has dawned in which novel drugs such as prasugrel and ticagrelor are providing new ways to improve patients' prognoses. This article reviews the evidence available on the use of different antiplatelet drugs in acute ST-segment-elevation myocardial infarction, with a focus on the use of new agents in primary angioplasty. It also considers other topics such as antiplatelet therapy during fibrinolysis, the current role of glycoprotein-IIb/IIIa inhibitors and treatment duration.