Benefit of ADP receptor antagonists in atherothrombotic patients: new evidence

Cerebrovascular Diseases
J Bogousslavsky

Abstract

In the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events (CAPRIE) trial, clopidogrel showed a statistically significant superiority over aspirin in the prevention of ischaemic stroke, myocardial infarction and vascular death in patients with symptomatic atherosclerosis. More recently, post-hoc analysis of the data also showed that repeat hospitalization for ischaemic or bleeding events was decreased with clopidogrel compared with aspirin. Complementary analyses show that the benefit of clopidogrel over aspirin is amplified in a large population at very high risk of further atherothrombotic events (diabetics, patients with high cholesterol, and patients with previous manifestations of atherothrombosis). A potential clinically useful advantage of clopidogrel is its low propensity for adverse interaction with angiotensin-converting enzyme (ACE) inhibitors, contrary to what may be seen with aspirin, as observed in a post-hoc CAPRIE analysis. The putative aspirin-ACE inhibitor interaction is being tested prospectively in the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial - a randomized comparison of warfarin, clopidogrel and aspirin in patients with chronic heart failure. The good gastroint...Continue Reading

Citations

Nov 15, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Ramazanali AhmadiErich Minar
Feb 5, 2002·Expert Opinion on Pharmacotherapy·K M Crawford, R L Talbert
Apr 9, 2004·Journal of Vascular Surgery·Andrea Willfort-EhringerHerbert Ehringer
Jun 1, 2016·Journal of Movement Disorders·Jinse Park
Nov 16, 2006·International Journal of Rehabilitation Research. Internationale Zeitschrift Für Rehabilitationsforschung. Revue Internationale De Recherches De Réadaptation·Josephine Hui Yung Ang, David Wai Kwong Man
May 12, 2011·International Journal of Stroke : Official Journal of the International Stroke Society·Simona SaccoAntonio Carolei

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