Smoking and antiplatelet agents – smoke and mirrors or something more?

Many antiplatelet therapies are prodrugs that require metabolic activation.  It has been hypothesized that smoking may activate this metabolic conversion for some antiplatelets (i.e. clopidogrel) more than others (i.e. prasugrel and ticagrelor).  In this systematic review and meta-analysis, the authors identified 9 randomized controlled trials of clopidogrel, prasugrel, or ticagrelor which examined outcomes among subgroups […]

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