Shervin Eshaghian, MD; Sanjay Kaul, MD; Sameer Amin, MD; Prediman K. Shah, MD; George A. Diamond, MD
Grant Support: None.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Sanjay Kaul, MD, Division of Cardiology, Room 5536, South Tower, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048; e-mail, email@example.com.
Current Author Addresses: Drs. Eshaghian, Kaul, Amin, Shah, and Diamond: Division of Cardiology, Room 5536, South Tower, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048.
Aspirin is the most widely used antiplatelet agent for preventing and treating vascular events. The thienopyridine derivatives, ticlopidine and clopidogrel, are a suitable alternative in patients who are intolerant to aspirin, and clopidogrel exhibits better tolerability than ticlopidine. The available evidence from randomized trials indicates that dual therapy with clopidogrel and aspirin is modestly but significantly more effective than aspirin in preventing serious vascular events. It is also associated with a favorable benefit–risk profile in patients at high risk (especially in acute coronary syndromes and after stenting). In patients at low risk (stable cardiovascular disease), however, the bleeding risk of dual therapy exceeds its potential benefit. The dose and duration of pretreatment before stenting, the optimal duration of treatment after drug-eluting stent implantation, concurrent administration of platelet glycoprotein IIb/IIIa inhibitors, and the exact mechanism and clinical relevance of clopidogrel resistance are unclear.
Learn more about subscription options.
Register Now for a free account.
Eshaghian S, Kaul S, Amin S, Shah PK, Diamond GA. Role of Clopidogrel in Managing Atherothrombotic Cardiovascular Disease. Ann Intern Med. 2007;146:434–441. doi: 10.7326/0003-4819-146-6-200703200-00008
Download citation file:
Published: Ann Intern Med. 2007;146(6):434-441.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only