Cardiovascular & Renal: Clopidogrel: A Novel Antiplatelet Drug for Prevention and Treatment of Thrombotic Disorders

Abstract

Thrombotic events of the arterial circulation continue to be the major cause of cardiovascular death in spite of great efforts to prevent and treat thrombosis. Current antithrombotic strategies in clinical use are primarily based on aspirin (antiplatelet), heparin (anticoagulant) and coumadins (chronic anticoagulants). Recently, ReoPro®, an antibody blocking the platelet fibrinogen receptor, GpIIb/IIIa, has been introduced for limited acute use for prevention of ischaemic complications of coronary balloon angioplasty. Clopidogrel is a novel antiplatelet agent that has demonstrated antithrombotic efficacy beyond aspirin in preclinical studies and is now in clinical (Phase II) development for secondary prevention of broad ischaemic cardiovascular events including death. Clopidogrel is an ADP receptor antagonist with additional properties that produce effective and long-lasting antithrombotic actions. Clopidogrel seems to be free of the adverse side-effects that flawed ticlopidine, a closely related thieno-derivative, and is at least six-fold more potent. It is expected that clopidogrel will add significantly to the antichrombotic arsenal and reduce cardiovascular morbidity and mortality above and beyond currently available therapy.