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Open Access Modern Antiplatelet Therapy: When Is Clopidogrel the Right Choice?

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

Platelet inhibition with aspirin is the cornerstone of medical therapy for coronary artery disease. In the era of percutaneous coronary intervention with drug-eluting stents, dual anti-platelet therapy with the addition of clopidogrel (Plavix©, Bristol-Myers Squibb, New York, NY) became the mainstay of therapy. However, with the advent of newer oral antiplatelet medications, including prasugrel (Effient©, Eli Lilly, Indianapolis, Indiana) and ticagrelor (Brilinta©, Astra-Zeneca, Cambridge, United Kingdom), choosing the appropriate platelet inhibitor has become more nuanced. The optimal regimen differs based on patient characteristics, clinical situation, and the condition being treated, with differing risk and safety profiles for these medications. This review explores the appropriate use of antiplatelet therapy for stable ischemic heart disease, acute coronary syndrome, stroke, and peripheral vascular disease. Furthermore, we evaluate the data behind the use of antiplatelet therapy in patients on oral anticoagulation. By understanding the biochemistry of platelet aggregation, the pharmacology of platelet inhibitors, and the extensive clinical trial data that informs current guideline recommendations we aim to better understand the role of clopidogrel in patients with cardiovascular disease.
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Keywords: P2Y12 inhibitor; acute coronary syndrome; antiplatelet therapy; stable coronary artery disease; thienopyridine

Document Type: Research Article

Publication date: July 1, 2018

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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