Toegevoegde waarde van clopidogrel in cardiologie en neurologie

Platelet aggregation inhibitors reduce the risk of complications during and after acute coronary syndromes and after a TIA or stroke. Acetylsalicylic acid plays a major role in secondary prevention; the combination of acetylsalicylic acid and a platelet ADP receptor antagonist, such as clopidogrel, may have added value. In percutaneous coronary intervention, dual platelet inhibition appears to be effective in the prevention of stent thrombosis. Long-term (> 1 year) use of dual platelet inhibition has an unfavourable risk-benefit profile, partly due to an increase in the number of bleeding events, particularly in the stomach. The use of the combination of acetylsalicylic acid and clopidogrel may be helpful after a TIA or minor stroke, but further research is needed to identify the group of patients for whom this combination would be applicable. This article provides an overview of the modern cardiological and neurological indications for platelet inhibition as well as the risk factors for severe bleeding events when using dual antiplatelet therapy.