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Clopidogrel: a review of its use in the prevention of thrombosis

Greg L Plosker1, Katherine A Lyseng-Williamson

  • 1Wolters Kluwer Health | Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Conshohocken, Pennsylvania, USA. demail@adis.co.nz

Drugs
|March 14, 2007
PubMed

Insights

Clopidogrel is an effective antiplatelet medication that reduces cardiovascular events, especially when added to aspirin therapy for acute coronary syndromes. It is a well-tolerated option for secondary prevention in various cardiovascular conditions.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Clopidogrel selectively and irreversibly inhibits adenosine diphosphate (ADP)-induced platelet aggregation.
  • Established cardiovascular disease patients showed a modest advantage of clopidogrel over aspirin in reducing adverse cardiovascular outcomes (CAPRIE trial).
  • Addition of clopidogrel to aspirin improved outcomes in acute coronary syndromes (CURE, COMMIT, CLARITY-TIMI 28 trials).

Purpose of the Study:

  • To evaluate the efficacy and tolerability of clopidogrel as an antiplatelet agent.
  • To assess clopidogrel's role in secondary prevention of ischemic events.
  • To review unresolved issues regarding clopidogrel use, such as optimal dosing and treatment duration post-PCI and stent placement.

Main Methods:

  • Analysis of results from large randomized trials including CAPRIE, CURE, COMMIT, and CLARITY-TIMI 28.
  • Review of clinical data on clopidogrel's impact on cardiovascular outcomes.
  • Examination of treatment guidelines from US and European bodies.

Main Results:

  • Clopidogrel demonstrated a statistically significant advantage over aspirin in reducing adverse cardiovascular outcomes in established cardiovascular disease.
  • Addition of clopidogrel to aspirin therapy significantly improved outcomes in patients with acute coronary syndromes.
  • Clopidogrel is established as an effective and well-tolerated agent for secondary prevention in ischemic stroke and acute coronary syndromes.

Conclusions:

  • Clopidogrel is a crucial antiplatelet agent for secondary prevention in patients with cardiovascular conditions.
  • Current evidence supports clopidogrel's efficacy and tolerability in managing cardiovascular risks.
  • Further research may be needed to address optimal dosing and duration for specific interventions like percutaneous coronary interventions (PCI).

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