[Indications for antiplatelet medications].
Platelet active drugs are part of the antithrombotics. Their biological effect is not assessed in current practice. Their clinical efficacy has been firmly established in randomised controlled trials. Aspirin has been the most widely tested drug and is effective in various forms of coronary artery disease and in the secondary prevention after a first ischaemic stroke; in these settings, aspirin reduces the incidence of myocardial infarction, stroke and cardiac death; aspirin has been tested in various daily doses from 30 to 1300 mg: best evidence has been gathered for dosages between 75 and 300 mg; good clinical practice is to use the lowest effective dose. Ticlopidine and clopidogrel have been shown to be superior to aspirin in 2 trials where the incidence of myocardial infarction has been lowered by the new drugs; nevertheless the superiority is apparent only in patients with lower limb atherosclerosis and after stroke. The combination of dipyridamole and aspirin has been proven to be superior to aspirin in the secondary prevention of stroke in one trial contrasting with the other trials performed with other combinations of those two drugs. Glycoprotein GP IIb/IIIa antagonists have been tested in coronary angioplasty and in acute coronary syndromes and only in short intravenous administration; these drugs reduce the incidence of myocardial infarction without any effect on 6-month mortality.
Castaigne
A
A
Fédération des services de médecine cardiologique, Hôpital Henri-Mondor, Créteil.
Benacerraf
S
S
Le Roux
A
A
D004305:Dose-Response Relationship, Drug; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D020521:Stroke / Q000517:prevention & control*
D010975:Platelet Aggregation Inhibitors
Indications des médicaments antiplaquettaires.