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What are antiplatelet medications?

Antiplatelet therapy is designed to keep platelets from forming dangerous clots. It currently includes three main medications: aspirin, clopidogrel, and aspirin with dipyridamole:
  • Aspirin. Aspirin is the mainstay of stroke treatment and prevention.  It is generally used in all stroke subtypes, with exception of strokes related to atrial fibrillation, fr warfarin is shown to provide better protection.  In addition to treating high blood pressure, diabetes, high cholesterol, and smoking cessation, aspirin is proven to be one of the most effective and safe therapies for stroke.

    The American Heart Association/American Stroke Association (AHA/ASA) guidelines for the treatment of acute ischemic stroke recommend that most patients begin taking aspirin within 24 to 48 hours after a stroke. The guidelines cite evidence of a small but significant decline in risk of illness and death when aspirin is started within this time frame. A significant limitation of aspirin is that it can cause gastrointestinal discomfort and bleeding.
  • Clopidogrel. Clopidogrel has fewer gastrointestinal side effects than aspirin, but it is more expensive. Doctors typically prescribe clopidogrel for people who can't tolerate aspirin or who are already taking clopidogrel for their heart.
  • Combination of aspirin and dipyridamole. The effectiveness of this combination in preventing stroke and transient ischemic attack (TIA), as well as its likelihood of causing side effects, is similar to that of aspirin or clopidogrel alone, but because it contains a lower dose of aspirin, it may be better tolerated in patients who are sensitive to aspirin.
When you are healing from an injury, your blood begins to clot because of platelets - cell fragments in blood that clump together to prevent bleeding. Platelets cause clotting at injury sites, but they can sometimes also clump at the site of plaque deposits in your arteries and contribute to a heart attack, stroke or other problems.

Antiplatelet therapy is prescribed for patients who have a build-up of a fatty substance called plaque in the arteries of their heart, neck (carotid) or limbs, and for patients who have had a heart attack or stroke. It is critically important for patients who have received a stent. Without medication, blood clots (called thrombosis) can form around the stent and block blood flow or break free and cause a blockage elsewhere in the body, resulting in a heart attack, stroke or even death. Current guidelines, developed by the Society for Cardiovascular Angiography and Interventions (SCAI) in conjunction with other key cardiology associations, recommend that patients who receive a bare metal stent take aspirin and an antiplatelet medication (such as Plavix or Effient) for at least a month after the procedure. Patients who receive drug-eluting (coated) stents are recommended to take aspirin and an antiplatelet medication for at least one year after stent implantation.

Taking aspirin and a second antiplatelet medication, such as Plavix or Effient, is called dual antiplatelet therapy (DAPT). If you are a patient who is about to undergo a medical procedure with a physician other than the cardiologist who prescribed implanted your stent, be sure to talk with both doctors. Guidelines about DAPT and procedures can change, so it is important to stay up to date. For example, new recommendations say that stent patients do not have to discontinue DAPT for gastrointestinal endoscopic procedures.

- Examples of Antiplatelet Medications:
aspirin
clopidogrel (Plavix)
dipyridamole (Persantine, Aggrenox)
prasugrel (Effient)
ticlopidine (Ticlid)
cilostazole (Pletal)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.