title: [Added value of clopidogrel in cardiology and neurology].
abstract: Platelet aggregation inhibitors reduce the risk of complications during and after acute coronary syndromes and after a TIA or stroke. Acetylsalicylic acid plays a major role in secondary prevention; the combination of acetylsalicylic acid and a platelet ADP receptor antagonist, such as clopidogrel, may have added value. In percutaneous coronary intervention, dual platelet inhibition appears to be effective in the prevention of stent thrombosis. Long-term (> 1 year) use of dual platelet inhibition has an unfavourable risk-benefit profile, partly due to an increase in the number of bleeding events, particularly in the stomach. The use of the combination of acetylsalicylic acid and clopidogrel may be helpful after a TIA or minor stroke, but further research is needed to identify the group of patients for whom this combination would be applicable. This article provides an overview of the modern cardiological and neurological indications for platelet inhibition as well as the risk factors for severe bleeding events when using dual antiplatelet therapy.
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Amsterdam.
authors.forename: Freek W A
authors.initials: FW
authors.lastname: Verheugt
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Geersing
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
mesh_terms: D054058:Acute Coronary Syndrome / Q000517:prevention & control; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D000077144:Clopidogrel; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000517:prevention & control; D013927:Thrombosis / Q000517:prevention & control; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin