Document Detail

Clopidogrel in the management of acute coronary syndromes: indications, results, obstacles.
MedLine Citation:
PMID:  19491569     Owner:  NLM     Status:  MEDLINE    
Atherothrombosis is the underlying pathology of the acute coronary syndromes (ACS), in which platelet activation plays a key role. Therefore, antiplatelet therapy is an essential component of guideline-recommended ACS management. Considerable evidence clearly demonstrates the benefits of the antiplatelet agent clopidogrel in reducing mortality, decreasing recurrent cardiovascular events, and increasing arterial patency in ACS patients. Despite this evidence, data from patient registries and clinical initiatives such as CRUSADE (Can Rapid stratification of Unstable angina Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association guidelines) and GRACE (Global Registry of Acute Coronary Events) indicate that clopidogrel is underused in patients with ACS. This is especially true for patients receiving conservative medical management, many of whom have significant risk for recurrent ischemic events. The purpose of this review is to compare "real-life" clopidogrel therapy with evidence-based guidelines, and to highlight clinical factors that drive clopidogrel implementation or provide barriers to its use in ACS patients.
Ezra A Amsterdam
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  8     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-03     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-54     Citation Subset:  IM    
Division of Cardiovascular Medicine, University of California (Davis) Medical Center, Sacramento, California 95817, USA.
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MeSH Terms
Acute Coronary Syndrome / drug therapy*
Platelet Aggregation Inhibitors / therapeutic use*
Ticlopidine / analogs & derivatives*,  therapeutic use
Treatment Outcome
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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