Anticoagulants, Antiplatelets and Thrombolytics, 2nd Edition

Book review

Anticoagulants, Antiplatelets and Thrombolytics, 2nd Edition

Edited by Shaker A. Mousa. Published by Humana Press, a part of Springer Science+Business Media (www.spinger.com),New York, Dordrecht, Heidelberg, London, 2010. 316 pp, price £99, ISBN: 978-1-60761-802-7

This volume is number 663 of the Methods in MolecularBiology series published by Humana Press. It is largely thework of Shaker A. Mousa who edited the volume, wrotenine of the 13 chapters and was a co-author of three of thefour remaining chapters. The book is 316 pages long.

The book is principally about drugs that act as antico-agulants and antiplatelet agents which are sometimesreferred to as antithrombotics. Actually, there is very littleon thrombolytic agents. Some chapters provide informa-tion on laboratory and other approaches to obtain infor-mation on the antithrombotic actions of anticoagulantsand antiplatelet agents. Others focus on clinical trials inwhich the effects of the agents have been tested in man.Others look to the possible future use of such agents incancer and sickle cell disorders.

The first chapter describes a range of in vitro methodsfor evaluating such drugs.The main focus is on approachesusing blood from animals after drug administration. Thereis a brief resumé of mechanisms involved in platelet adhe-sion to subendothelial surfaces, platelet aggregation andcoagulation. This is followed by a description of coagula-tion and platelet aggregation testing and also somethingon erythrocyte deformability and rigidity.The chapter con-cludes with an assessment of the use of a cone-and-plateviscometer and a flow chamber.

Chapter 2 is the longest chapter in the book occupyingsome 90 pages. It describes animal models for drug evalu-ation and is quite comprehensive. It contains a wealth oftechnical detail regarding stasis models, vascular injurymodels for testing antithrombotics and also knock-outs forexamination of the relevance of specific pathways relevantto haemostasis and thrombosis.

Chapter 3 provides specific information on the clinicalbenefits of the anticoagulants, heparin and low-molecularweight heparins. Heparin use is not without risk andChapter 4 focuses on heparin-induced thrombocytopenia,laboratory tests for its diagnosis, and subsequent clinicalmanagement through use of alternative therapies.Chapter

5 describes anticoagulant therapies other than heparinand moves the focus to the use of oral agents and thosethat do not require monitoring or dose adjustment.Follow-ing this chapter 6 focuses specifically on the oral directFactor Xa inhibitors with special emphasis on rivaroxaban.

Chapter 7 turns to antiplatelet therapies, focusingmainly on use of the P2Y12 antagonist clopidogrel and theoutcomes of clinical trials in which this drug has been usedwith aspirin. There is brief mention of the emergence ofAZD6140, a reversible P2Y12 antagonist, which is nowknown as ticagrelor. Chapter 8 is about clinical trials involv-ing prasugrel, a novel P2Y12 antagonist that appears to bemore effective than clopidogrel.

Chapter 9 is about naturally derived products with animpact on coagulation and platelet function. Chapter 10speculates on the potential value of anticoagulant and anti-platelet agents as assessed using animal models of experi-mental lung metastasis. Chapter 11 is about adhesionmolecules on various cell types and approaches to interferewith their involvement in physiological and pathologicalprocesses. Chapter 12 describes the value of genetic infor-mation in improving the safety of pharmacotherapy.Chapter 13 is on the diagnosis and management of sicklecell disorders.The book concludes with a subject index.

This volume is largely written by the head of a team ofexperimentalists and researchers in the antithrombotics areafor other experimentalists and researchers.The broad subjectmatter provides useful information for non-clinical labora-tory researchers and also clinical scientists. It is quite compre-hensive as far as anticoagulants and antiplatelet agents areconcerned, but, despite the title, I would be disappointed if Iwere hoping to obtain information on where we are in theinvestigation and use of thrombolytics in 2010.

Competing Interests

There are no competing interests to declare.

Stan HeptinstallProfessor of Thrombosis and Haemostasis, University of Nottingham

CORRESPONDENCEStan Heptinstall, Cardiovascular Medicine, Queens MedicalCentre, Nottingham NG7 2UH, UK.E-mail: s.heptinstall@nottingham.ac.uk

RECEIVED29 November 2010

ACCEPTED19 January 2011

ACCEPTED ARTICLE31 January 2011

British Journal of ClinicalPharmacology

DOI:10.1111/j.1365-2125.2011.03927.x

Br J Clin Pharmacol / 72:4 / 719 / 719© 2011 The AuthorBritish Journal of Clinical Pharmacology © 2011 The British Pharmacological Society