Clopidogrel and risk for acute coronary events

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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Published on: March 15, 2022

Girish R Mood1, Deepak L Bhatt

  • 1Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk F25, Cleveland, OH 44195, USA.

Current Atherosclerosis Reports
|November 16, 2007
PubMed

Insights

Clopidogrel bisulfate effectively prevents platelet aggregation and thrombus formation, outperforming aspirin for atherothrombotic diseases. Dual antiplatelet therapy with clopidogrel and aspirin is beneficial post-percutaneous coronary intervention and for acute coronary syndromes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis

Background:

  • Clopidogrel bisulfate is a potent P2Y12 receptor antagonist.
  • It irreversibly inhibits platelet aggregation by blocking adenosine diphosphate (ADP) binding.
  • This mechanism prevents activation of the glycoprotein IIb/IIIa pathway, reducing thrombus formation.

Purpose of the Study:

  • To review the benefits of clopidogrel as an antiplatelet agent.
  • To discuss the role of clopidogrel in managing acute coronary syndromes (ACS).
  • To evaluate the efficacy of clopidogrel in patients undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • Review of existing clinical studies and pharmacological data on clopidogrel.
  • Comparison of clopidogrel's efficacy against aspirin in atherothrombotic diseases.
  • Analysis of dual antiplatelet therapy (DAPT) regimens, including clopidogrel plus aspirin.

Main Results:

  • Clopidogrel demonstrated superiority over aspirin in treating atherothrombotic conditions.
  • Dual antiplatelet therapy (clopidogrel plus aspirin) is highly effective in ACS and post-PCI.
  • No significant benefit of DAPT was observed for primary prevention.

Conclusions:

  • Clopidogrel is a key antiplatelet medication for preventing thrombotic events.
  • DAPT involving clopidogrel is a cornerstone in the management of ACS and post-PCI.
  • The use of DAPT should be carefully considered, with no current indication for primary prevention.

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