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Ticlopidine and clopidogrel.

M J Quinn1, D J Fitzgerald

  • 1Department of Clinical Pharmacology, The Royal College of Surgeons in Ireland, Dublin, Ireland.

Circulation
|October 12, 1999
PubMed
Summary
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Thienopyridines like ticlopidine and clopidogrel inhibit platelet aggregation by blocking ADP receptors. While effective in preventing cardiovascular events, ticlopidine has serious side effects, and clopidogrel

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Hematology

Background:

  • Thienopyridines, including ticlopidine and clopidogrel, are established inhibitors of platelet aggregation.
  • Their mechanism involves conversion to active metabolites that antagonize platelet ADP receptors.
  • Platelet inhibition onset is delayed, with maximum effect after several days and slow recovery.

Purpose of the Study:

  • To review the efficacy and safety profiles of ticlopidine and clopidogrel.
  • To compare their effectiveness against aspirin in preventing cardiovascular events.
  • To identify outstanding questions regarding clopidogrel's role, especially in combination with aspirin.

Main Methods:

  • Literature review of studies on thienopyridine antiplatelet agents.

Related Experiment Videos

  • Analysis of clinical trial data comparing ticlopidine and clopidogrel with aspirin.
  • Evaluation of reported adverse events and therapeutic outcomes.

    • Main Results:

    • Ticlopidine demonstrates efficacy comparable to aspirin in vascular disease but carries risks of severe adverse reactions like neutropenia.
    • Clopidogrel is as effective as aspirin and appears safer than ticlopidine.
    • Efficacy data for clopidogrel in acute coronary syndromes and post-stent placement are limited.

    Conclusions:

    • Clopidogrel offers a potentially safer alternative to ticlopidine for cardiovascular event prevention.
    • Further research is needed to determine the added benefit and safety of combining clopidogrel with aspirin.
    • The combination of clopidogrel and aspirin may represent a future standard in antithrombotic therapy.