Defining the optimal dose of aspirin and clopidogrel in acute coronary syndromes. Evaluation of ‘Dose comparisons of clopidogrel and aspirin in acute coronary syndromes’, N Engl J Med 2010;363:930-42.
Platelet inhibition is integral to the contemporary management of acute coronary syndromes. While aspirin and clopidogrel are used almost universally in patients treated with an early invasive strategy, the optimal dosing strategy for these drugs remains unknown. In a large randomized trial, the OASIS-CURRENT 7, investigators demonstrated no benefit of a higher dose of aspirin. There was no overall benefit of a higher dose of clopidogrel, although in patients treated with percutaneous coronary intervention a double-dose strategy was associated with a reduction in stent thrombosis and other ischemic events at the cost of an increased risk of bleeding events.
University of Michigan Health System, Division of Cardiovascular Medicine, University of Michigan Cardiovascular Center, 2A394, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5853, USA. hgurm@med.umich.edu
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