| Antiplatelet agents
in a nutshell |
| Medication |
Pros |
Cons |
Aspirin
(50-325 mg /d) |
- Relatively safe, inexpensive
- First line agent
- Reduce stroke risk by 15% compared
w placebo
|
|
Clopidrogel (Plavix)
75 mg qd |
- about as safe as Aspirin
- about as effective as Aspirin in
preventling stroke and heart attack
- May be better than aspirin in
patient with peripheral vascular disease
|
- Cost about $110/month
- rate of diarrhea, rash, and pruritus was
higher than with aspirin
- Rare TTP (about 4 per
million)
|
| Aspirin plus Clopidrogel |
-
MATCH
Results
-
Compared to clopidogrel 75 mg
alone, clopidogrel plus acetylsalicylic acid (ASA) 75 mg had no
significant effect on recurrent ischemic events. 15.7% of patients
taking clopidogrel + ASA had a further ischemic event vs 16.73% of
patients taking clopidogrel + placebo (p=.244). Patients taking
clopidogrel + ASA also experienced significantly more
life-threatening hemorrhage compared to patients taking
clopidogrel + placebo (2.6% vs 1.3%, p<0.001).
|
Aspirin 25 mg plus
extended release Dipyridamole 200 mg
(Aggrenox 1 bid) |
- Combination of Aspirin and
dipyridamole is better than
Aspirin 50 mg/day in preventing stroke
|
- Dipyridamole is a vasodilator, may
cause headache
- Cost about $110/month
- little effect on fatal stroke and
myocardial infarction.
|
| Aggrenox vs ASA + Plavix |
|
