Related Experiment Video
Updated: Aug 14, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Clopidogrel in acute coronary heart disease
Jehangir N Din1, Keith A A Fox
1Centre for Cardiovascular Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, Scotland.
Insights
Dual antiplatelet therapy combining aspirin and clopidogrel significantly lowers adverse cardiac events in acute coronary syndromes and after percutaneous coronary intervention. Further research is needed to optimize treatment duration and identify patients benefiting from glycoprotein IIb/IIIa inhibitors.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Pharmacology
Background:
- Atherothrombosis involves platelet aggregation, leading to myocardial infarction.
- Conventional aspirin therapy has limitations in preventing recurrent ischemic events.
- Potent antiplatelet agents like clopidogrel offer enhanced inhibition of platelet activation.
Purpose of the Study:
- To review the role of potent antiplatelet agents in atherothrombosis.
- To evaluate the efficacy of combination therapy with clopidogrel and aspirin.
- To identify areas for further research in antiplatelet treatment strategies.
Main Methods:
- Review of large clinical trials on antiplatelet therapy.
- Analysis of data concerning combination therapy with clopidogrel and aspirin.
- Assessment of mechanisms of action for thienopyridines.
Main Results:
- Combination therapy with clopidogrel and aspirin significantly reduces adverse cardiac events.
- Irreversible blockade of the platelet adenosine diphosphate receptor by these drugs inhibits platelet aggregation.
- Evidence supports their use in acute coronary syndromes and percutaneous coronary intervention.
Conclusions:
- Combination antiplatelet therapy is effective in managing atherothrombosis.
- Optimal dosing and treatment duration require further investigation.
- Patient selection for additional glycoprotein IIb/IIIa inhibition needs refinement.
Abstract:
Platelets play a central role in the pathogenesis of atherothrombosis. Rupture of a coronary artery plaque creates a nidus for platelet aggregation and thrombus formation, which may result in vessel occlusion and subsequent myocardial infarction or death. Despite conventional antiplatelet therapy with aspirin, the risk of recurrent ischemic events remains high. More potent antiplatelet agents have therefore been developed, including the thienopyridines ticlopidine and clopidogrel. By irreversibly blocking the platelet adenosine diphosphate receptor, these drugs powerfully inhibit platelet activation, degranulation, and aggregation. Large clinical trials have demonstrated that combination antiplatelet therapy with clopidogrel and aspirin significantly reduces the risk of adverse cardiac events in patients with acute coronary syndromes and in those undergoing percutaneous coronary intervention. The optimal loading dose and length of treatment, however, are yet to be firmly established, and there is a need to clearly identify those patients who will benefit most from additional glycoprotein IIb/IIIa inhibition.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:26Acute Coronary Syndrome V: Nursing Management
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations