In a phase 2 trial, vorapaxar showed a trend toward lower incidence of major adverse cardiovascular events (MACE) without differences of major and minor bleeding in patients scheduled for angiography and possible coronary stenting. 11) However, in a recent large randomized clinical trial, the addition of vorapaxar to standard therapy in patients with non-ST elevation acute coronary syndrome did not reduce MACE but significantly increased the risk of major bleeding, including intracranial hemorrhage. 12) Thromboxane A 2 Thromboxane A 2 is produced from arachidonic acid through conversion by cyclooxygenase-1 and thromboxane synthase.
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