Journal Mobile

TO Mudawi, L Morrison
Journal Issue: 
Volume 38: Issue 2: 2008




Since  its  introduction  as  a  new  anti-platelet  agent  a  decade  ago, clopidogrel  has  been  shown  to  be  a  useful  drug  in  the  treatment  of  non-ST elevation acute coronary syndromes. Its use in such conditions has been advocated by  national  UK,  European  and  international  guidelines  issued  by  a  number  of professional regulatory authorities. However, in the past few years, new evidence has  emerged  from  a  number  of  clinical  trials  supporting  the  expansion  of clopidogrel  use  to  include  ST  elevation  myocardial  infarction  and  patients undergoing  both  urgent  and  elective  percutaneous  coronary  interventional procedures in the form of an initial loading dose followed by a daily maintenance dose, usually for a period of 12 months. This review paper aims to highlight areas in clinical practice where clopidogrel use does not follow the agreed guidelines. It also compares the published UK, European and international guidelines with the up-to-date evidence that recently became available from clinical trials. The paper also  outlines  some  suggested  recommendations  to  be  considered  when  issuing any new clopidogrel-related guidance documents.