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The role of platelets in atherogenesis, acute coronary syndrome and the development of complications from percutaneous coronary intervention is relatively well known. Until recently, aspirin was the only antiplatelet agent available for the primary and secondary prevention of coronary heart disease. Recently, there has been a substantial expansion in the antiplatelet armamentarium as well as in the understanding of the clinical importance of antiplatelet therapy in patients with coronary heart disease. The benefits and limitations of the currently available antiplatelet agents including aspirin, thienopyridines (ticlopidine and clopidogrel), and the platelet glycoprotein IIb/IIIa inhibitors in the primary and secondary prevention of coronary heart disease and special clinical situations, such as unstable angina, acute myocardial infarction and percutaneous coronary intervention are discussed.