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Clopidogrel: an updated and comprehensive review
1The University of Edinburgh, SU305 Chancellor's Building, Little France Crescent, Edinburgh, EH16 4SA, UK.
Expert Opinion on Drug Metabolism & Toxicology
|August 19, 2007
Summary
Adding clopidogrel to aspirin significantly improves outcomes for acute coronary syndrome patients. This combination therapy is crucial for non-ST-elevation and ST-elevation myocardial infarctions, and percutaneous coronary interventions.
Area of Science:
- Cardiology
- Pharmacology
- Internal Medicine
Background:
- Acute coronary syndrome (ACS) carries substantial risks despite aspirin use.
- Dual antiplatelet therapy with aspirin and clopidogrel shows improved outcomes in ACS.
- Current treatment paradigms for ACS are evolving.
Purpose of the Study:
- To review the evidence for clopidogrel use in various ACS settings.
- To discuss therapeutic implications of clopidogrel in ACS management.
- To explore combination therapy with other antithrombotics.
Main Methods:
- Review of clinical evidence and therapeutic implications.
- Discussion of clopidogrel in non-ST-elevation ACS (NSTE-ACS).
- Evaluation of clopidogrel in ST-elevation ACS (STEMI) and percutaneous coronary intervention (PCI).
Main Results:
- Clopidogrel combined with aspirin significantly improves outcomes in ACS.
- Evidence supports clopidogrel use in NSTE-ACS and STEMI.
- Combination therapy with glycoprotein IIb/IIIa inhibitors and direct thrombin inhibitors is considered.
Conclusions:
- Clopidogrel has fundamentally altered ACS treatment strategies.
- Dual antiplatelet therapy is a cornerstone in managing ACS.
- Further research may explore optimal antithrombotic combinations.
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