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Clopidogrel

The Data, the Experience, and the Controversies

  • Review Article
  • Published:
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Abstract

Dual antiplatelet therapy with acetylsalicylic acid (aspirin) and clopidogrel is a guideline-recommended standard of care for patients with acute coronary syndromes (ACS) and those who undergo percutaneous coronary intervention (PCI). Despite a large body of clinical evidence obtained from randomized clinical trials and patient registries supporting the efficacy and safety of aspirin plus clopidogrel therapy in these patients, questions concerning the optimal use of dual antiplatelet therapy remain. Widely debated topics pertaining to dual antiplatelet therapy in patients with ACS or undergoing PCI include (i) the appropriate clopidogrel loading dose; (ii) the optimal time to initiate the clopidogrel loading dose; (iii) the optimal duration of dual antiplatelet therapy following ACS or PCI; (iv) impact of variability of platelet response on patient outcomes; and (v) the role of other recommended and emerging P2Y12 antagonists. This review discusses these ongoing controversies regarding the optimal use of dual antiplatelet therapy with aspirin and clopidogrel in patients with ACS or those undergoing PCI.

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Acknowledgments

This manuscript was written and edited by the authors, who take full responsibility for its content. Editorial assistance with searching the literature, coordinating revisions, and creating figures and tables in preparation of this manuscript was provided by Susan Abulhawa and Melanie Leiby, PhD, of inScience Communications, Springer Healthcare, and funded by the Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership. The authors did not receive any compensation for this work.

Saihari Sadanandan, MD, has served as a consultant and on the speaker’s bureau for Bristol-Myers Squibb and sanofi-aventis. Dr Sadanandan has also served on the speaker’s bureau for Daiichi Sankyo, Inc., Eli Lilly and Company, and Schering-Plough.

Inder M. Singh, MD, reports no conflicts of interest.

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  1. Indiana University Health, MCP 2, Suite D4078, 1801 N. Senate Blvd, Indianapolis, IN, 46202, USA

    Saihari Sadanandan

  2. Mercy Heart & Vascular Institute, Catholic Healthcare West Medical Foundation, Sacramento, CA, USA

    Inder M. Singh

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Sadanandan, S., Singh, I.M. Clopidogrel. Am J Cardiovasc Drugs 12, 361–374 (2012). https://doi.org/10.1007/BF03262471

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