Parameters:
(1) initial choice of oral antiplatelet therapy
(2) presence of coronary artery disease
(3) recurrent TIA or stroke
(4) occurrence of an acute coronary syndrome (ACS)
Initial choice of oral antiplatelet therapy can either be:
(1) aspirin
(2) clopidogrel
(3) aspirin plus extended release (ER) dipyridamole, provided the patient has no history of coronary artery disease
Factors that may be considered in initial choice:
(1) allergic reactions to aspirin
(2) cost
(3) aspirin resistance
Indications for switching to aspirin + clopidogrel:
(1) recurrent TIA/stroke
(2) acute coronary syndrome
Alternatives to aspirin + clopidogrel:
|
Initial Drug
|
Coronary Artery Disease
|
Subsequent Disorder
|
Alternative Drug
|
|
aspirin
|
yes
|
TIA/stroke
|
clopidogrel
|
|
aspirin
|
yes
|
ACS
|
clopidogrel
|
|
aspirin
|
no
|
TIA/stroke
|
clopidogrel
|
|
aspirin
|
no
|
TIA/stroke
|
aspirin and extended release dipyridamole
|
|
clopidogrel
|
no
|
TIA/stroke
|
aspirin and extended release dipyridamole
|
|
aspirin and extended release dipyridamole
|
no
|
TIA/stroke
|
clopidogrel
|
