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Nat. Rev. Cardiol. doi:10.1038/nrcardio.2015.113 Figure 1 Metabolism and mechanism of action of P2Y12-receptor inhibitors Figure 1 | Metabolism and mechanism of action of P2Y12-receptor inhibitors. P2Y receptors are a family of purinergic G-protein-coupled receptors and are activated by extracellular nucleotides, such as ADP. Platelets express at least two ADP receptors, P2Y1 and P2Y12, which couple to Gq and Gi proteins, respectively. Clopidogrel, prasugrel, ticagrelor, and cangrelor bind to the P2Y12 receptor and ultimately inhibit platelet activation and aggregation processes by modulating intraplatelet levels of cAMP and VASP-P. Abbreviations: CYP, cytochrome P450; PKA, cAMP-dependent protein kinase; VASP, vasodilator-stimulated phosphoprotein; VASP-P, phosphorylated VASP. Modified with permission from Nature Publishing Group © Franchi, F., & Angiolillo, D. J. Novel antiplatelet agents in acute coronary syndrome. Nat. Rev. Cardiol. 12 (1), 30–47 (2015). Modified with permission from Nature Publishing Group © Franchi, F., & Angiolillo, D. J. Novel antiplatelet agents in acute coronary syndrome. Nat. Rev. Cardiol. 12 (1), 30–47 (2015) Rollini, F. et al. (2015) Switching P2Y12-receptor inhibitors in patients with coronary artery disease Nat. Rev. Cardiol. doi:10.1038/nrcardio.2015.113