The role of modern antithrombotic agents in cardiovascular disease prevention

[摘要] Atherosclerosis is one of the most urgent problems in modern cardiology. Atherosclerosis instability and coronary heart disease clinical course are based on plaque ulceration, rupture, and atherothrombosis. Atherothrombosis causes 28% of all deaths worldwide. Therefore, usage of medications targeted on atherosclerosis is very important. One of such agents is clopidogrel - thienopyridine, first used in patients with effort angina, stroke (S), or peripheral artery disease, PAD (1997). Clopidogrel demonstrates polyvalent anti-aggregant effects on platelets. Adding clopidogrel to standard therapy improves outcomes in non-ST elevation acute coronary syndrome patients of low, intermediate, and high risk. Relative risk (RR) of death, myocardial infarction (MI), and S decreases by 20%, irrespective of standard treatment. In patients with recent MI, S, or severe PAD, long-term (three-year) clopidogrel treatment reduces RR of MI, S, or cardiovascular death by 8,7%, comparing to aspirin treatment. Clopidogrel prevents ischemic events more effectively (by 26%) than aspirin

[关键词] atherosclerosis;atherothrombosis;myocardial infarction;stroke;clopidogrel