They are widely used in primary and secondary prevention of thrombotic cerebrovascular or cardiovascular disease.
Choice of antiplatelet drug
A recent review [1] states: "....low-dose aspirin increases the risk of major bleeding 2-fold compared with placebo. However, the annual incidence of major bleeding due to low-dose aspirin is modest—only 1.3 patients per thousand higher than what is observed with placebo treatment. Treatment of approximately 800 patients with low-dose aspirin annually for cardiovascular prophylaxis will result in only 1 additional major bleeding episode." Further, "...the cost to prevent one major GI bleeding episode from aspirin in 1 year by substituting clopidogrel therapy would be $1,216,180..."
Antiplatelet drugs
The most important antiplatelet drugs are:
- Cyclooxygenase inhibitors
-
Adenosine diphosphate receptor inhibitors
- Clopidogrel (Plavix)
- Ticlopidine (Ticlid)
-
Phosphodiesterase inhibitors
- Cilostazol (Pletal)
-
Glycoprotein IIB/IIIA inhibitors (intravenous use
only)
- Abciximab (ReoPro)
Eptifibatide (Integrilin)
Tirofiban (Aggrastat)
- Abciximab (ReoPro)
-
Adenosine reuptake inhibitors
- Dipyridamole (Persantine)