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Published on: February 28, 2012
Clopidogrel: the data, the experience, and the controversies.
Saihari Sadanandan1, Inder M Singh
1Indiana University Health, Indianapolis, IN 46202, USA. ssadanana@iupui.edu
Summary
Dual antiplatelet therapy with aspirin and clopidogrel is standard for acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI). This review examines optimal dosing, timing, duration, and alternatives for this crucial treatment.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is standard for acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI).
- Extensive evidence supports DAPT's efficacy and safety in these patient populations.
- However, optimal clinical use remains debated.
Purpose of the Study:
- To review and discuss controversies surrounding the optimal use of DAPT with aspirin and clopidogrel.
- To address key areas of debate in DAPT management for ACS and PCI patients.
Main Methods:
- Literature review of randomized clinical trials and patient registries.
- Discussion of ongoing controversies and clinical questions regarding DAPT.
Main Results:
- Key debated topics include clopidogrel loading dose and timing.
- Optimal DAPT duration and the impact of platelet response variability are discussed.
- The role of alternative P2Y₁₂ antagonists is also considered.
Conclusions:
- Optimal use of aspirin and clopidogrel DAPT in ACS and PCI requires careful consideration of several factors.
- Further research and clinical consensus are needed to address current controversies.
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