The safety and efficacy of aspirin and clopidogrel as a combination treatment in patients with coronary heart disease

Abstract

The use of aspirin and clopidogrel in combination has become part of the standard clinical care of patients with coronary artery disease. The use of this combination provides significant benefits compared with the use of aspirin alone in patients with acute coronary syndromes, and in patients treated with percutaneous coronary intervention with stent placement (both bare metal and drug-eluting stents). Clinical trials have demonstrated significant efficacy of this dual therapy; however, there is the potential for significant bleeding complications from the synergistic antiplatelet effects. In total, it appears that when there is vessel injury (mechanical from perctutaneous coronary intervention or a ruptured plaque), dual antiplatelet therapy with aspirin and clopidogrel results in improved outcomes, albeit with a small but significant inherent risk of increased bleeding.

Keywords::

• aspirin
• atherothrombosis
• blood platelet
• clopidogrel
• coronary artery disease

Acknowledgement

G Cooke is supported by NIH/NHLBI career development grant K23 HL004483 (Bethesda, MD, USA). G Cooke and P Goldschmidt-Clermont have received past research grant support from Bristol-Myers Squib/Sanofi-Synthelabo. G Cooke has previously received honoraria from Bristol-Myers Squib for educational activities.