Shechar Dworski, MSc

Aspirin has been the traditional drug of choice for preventing cardiovascular events in cerebrovascular, cardiovascular, and peripheral vascular disease. However, many recent studies comparing aspirin to ticlopidine and clopidogrel in terms of efficacy and side effects, have produced results which favor these new antiplatelet drugs. Clopidogrel is the newer of the two drugs, and consequently, fewer studies have been done with it. Still, clopidogrel has shown promise as an alternative to ticlopidine; it is safer and has similar efficacy. However, studies are lacking to show that clopidogrel works equally well in all possible clinical situations, whereas ticlopidine's effectiveness has been proven in settings such as post-coronary stent insertion. Nevertheless, studies done with clopidogrel have shown it to be useful in many instances, such as secondary prevention after an initial cerebrovascular (TIA/ stroke) event. Most studies compare the two drugs against aspirin, but not directly against each other. Even so, it has become clear that clopidogrel produces fewer side effects, and is safer than ticlopidine. This article will present some of the information available about these two drugs to help the reader decide which antiplatelet agent to use.