[Platelet aggregation inhibitor in general practice. Every 3rd infarct prevented--reinfarction rate cut in half]

Depending on their mode of action, pharmaceuticals with an antithrombocytic effect are divided into five groups. In the doctor's office, acetylsalicylic acid (ASA) and the thienopyridines, such a ticlopidine and clopidogrel predominate. Acetylsalicylic acid should be considered for primary prevention in patients over 50 with a marked cardiovascular risk profile. In the secondary prophylaxis of myocardial infarction, life-long ASA treatment continues to be the treatment of choice. As an alternative, however, clopidogrel may be applied. A combination of acetylsalicylic acid and clopidogrel is recommended for patients who have been implanted with a stent. In patients with acute coronary syndrome, this regimen is superior to monotherapy with acetylsalicylic acid. In comparison with ticlopidine, clopidogrel has a more rapid onset of action, and has fewer side effects. In patients with an acute coronary syndrome and an elevated risk glycoprotein IIb/IIIa antagonists have proved highly effective.