American Journal of Cardiovascular Drugs

, Volume 12, Issue 6, pp 361–374


The Data, the Experience, and the Controversies
Review Article

DOI: 10.1007/BF03262471

Cite this article as:
Sadanandan, S. & Singh, I.M. Am J Cardiovasc Drugs (2012) 12: 361. doi:10.1007/BF03262471


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.

Copyright information

© Springer International Publishing AG 2012

Authors and Affiliations

  1. 1.Indiana University HealthIndianapolisUSA
  2. 2.Mercy Heart & Vascular InstituteCatholic Healthcare West Medical FoundationSacramentoUSA