Emerging Antiplatelet Agents: Revised Applications, Novel Targets, and Future Directions.

Current antiplatelet therapies reduce thrombotic, particularly atherothrombotic events but remain constrained by bleeding risk, residual ischemic events, and pharmacokinetic or pharmacogenomic limitations. This review first evaluates the evolving strategies to optimize established agents, including P2Y12 monotherapy, genotype-guided de-escalation, aspirin formulation research, and aspirin in cancer chemoprevention. Second, it examines emerging agents designed for prehospital use in acute myocardial infarction and CYP2C19-independent clopidogrel alternatives aimed at improving global access. Finally, novel molecular targets including glycoprotein VI, protease-activated receptor 4, 12-lipoxygenase, and glycoprotein Ibα that aim to decouple thrombosis from hemostasis are discussed.