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Published on: March 15, 2022

Clopidogrel in coronary artery disease: update 2012

Kurt Huber1

  • 13rd Department of Internal Medicine, Wilhelminen Hospital, Vienna, Austria. kurt.huber@wienkav.at

Advances in Cardiology
|August 22, 2012
PubMed

Insights

Clopidogrel remains a key antiplatelet therapy for coronary artery disease patients. Newer agents like prasugrel and ticagrelor are superior for acute coronary syndromes due to clopidogrel non-responsiveness.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis

Background:

  • Clopidogrel was the standard P2Y12 inhibitor for coronary artery disease (CAD) patients, used with aspirin.
  • Newer agents, prasugrel and ticagrelor, demonstrate superior efficacy in acute coronary syndromes (ACS).
  • This superiority is linked to a significant non-response rate (up to 30%) to clopidogrel in ACS patients.

Purpose of the Study:

  • To review the current understanding of clopidogrel's role in CAD management.
  • To summarize the latest evidence on clopidogrel's efficacy and indications.
  • To highlight the continued relevance of clopidogrel in specific patient populations.

Main Methods:

  • Literature review of recent studies on P2Y12 inhibitors.
  • Analysis of clinical trial data comparing clopidogrel, prasugrel, and ticagrelor.
  • Synthesis of information on clopidogrel response variability.

Main Results:

  • While prasugrel and ticagrelor outperform clopidogrel in ACS, clopidogrel remains effective for many CAD patients.
  • Genetic and non-genetic factors contribute to clopidogrel non-responsiveness in up to 30% of ACS cases.
  • Clopidogrel still has a significant role in the majority of CAD patients, particularly in elective settings.

Conclusions:

  • Clopidogrel continues to be a valuable antiplatelet option for a substantial portion of patients with coronary artery disease.
  • Understanding patient response variability is crucial for optimizing antiplatelet therapy selection.
  • This review provides an updated perspective on clopidogrel's place in modern cardiovascular pharmacotherapy.

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