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Oral Antiplatelet Therapy in the Secondary Prevention of Atherothrombotic Events

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Abstract

Atherothrombosis is the leading cause of death worldwide and has a large economic impact. It is a pathologic process related to atherosclerosis, which leads to adverse clinical manifestations, including acute coronary syndrome, cerebrovascular disease, and peripheral arterial disease. Patients with atherothrombosis are at heightened risk for recurrent ischemic events or death, and therefore, secondary prevention is an important goal in the treatment of these patients. Antiplatelet therapies available for long-term secondary prevention include aspirin (acetylsalicylic acid), extended-release dipyridamole plus aspirin, and clopidogrel. A number of clinical trials have demonstrated the benefit of combined antiplatelet therapy in secondary prevention, supporting the recommendations made in current published guidelines. Although the efficacy and safety of antiplatelet agents is well established and supported by clinical trials, their utilization rate in patients with atherothrombosis remains suboptimal. Quality improvement initiatives have demonstrated effectiveness in promoting the awareness and implementation of treatment guidelines. This article reviews the benefits and risks of antiplatelet therapy in patients with cardiovascular disease with the aim of spurring greater adherence to treatment recommendations and, thereby, better patient outcomes.

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Acknowledgments

Editorial assistance for the development of this manuscript was provided by Susan Abulhawa, with the financial support of the BMS/sanofi-aventis Pharmaceuticals Partnership. No honorarium was received by the authors for the preparation of this manuscript. Dr Ling has previously received speakers’ honoraria from sanofi-aventis and BMS. Dr Ovbiagele has served as a consultant in the last 5 years to Boehringer-Ingelheim, sanofi-aventis and Bayer Pharmaceuticals, and has also received speakers’ honoraria from Boehringer-Ingelheim and BMS. The opinions expressed in this work belonging to Dr Geoffrey Ling are his alone. They are not, and should not be inferred as, representative or endorsements of the Uniformed Services University, US Army, Department of Defense, or the US Government.

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  1. Department of Neurology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA

    Geoffrey Ling

  2. Stroke Center and Department of Neurology, University of California at Los Angeles Medical Center, Los Angeles, California, USA

    Bruce Ovbiagele

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Correspondence to Geoffrey Ling.

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Ling, G., Ovbiagele, B. Oral Antiplatelet Therapy in the Secondary Prevention of Atherothrombotic Events. Am J Cardiovasc Drugs 9, 197–209 (2009). https://doi.org/10.1007/BF03256575

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