Aspirin and newer orally active antiplatelet agents in the treatment of the post-myocardial infarction patient.

Abstract

The thienopyridine derivatives, ticlopidine and clopidogrel, provide alternatives to aspirin for use in the prevention of recurrent ischemic events in the post-myocardial infarction patient. These drugs act through a different mechanism than aspirin and, as a result, have potentially different profiles of safety and efficacy. The following discusses the clinical data collected supporting the use of these drugs for secondary prevention and the unanswered questions that remain regarding their use in subpopulations of individuals at risk. Based on the available data, it may be concluded that aspirin should remain the drug of choice for the prevention of recurrent ischemic events in the majority of patients who have suffered a recent myocardial infarction.