ANTIPLATELET AGENTS (INHIBITORS OF PLATEL ET-FUNCTION) ADMINISTERED ORALLY - BASES FOR THEIR USE IN CORONARY-ARTERY DISEASE

Long-term antithrombotic therapy, administered orally, is necessary in all patients with symptomatic coronary artery disease; the most commo nly used drugs are those which inhibit platelet aggregation. Aspirin a nd ticlopidine do not act on the same point of platelet function. They have the common property of inhibiting platelet function irreversibly and of partially inhibiting platelet aggregation. Flurbiprofenee acts like aspirin on thromboxane synthesis but the effect is reversible in 24 hours. The full effect of ticlopidine is only observed after sever al days' administration. The association of aspirin and ticlopidine is used over short periods after implantation of a stent. The dosage of ticlopidine is 2 tablets per day; that of aspirin is not well establis hed (100 to 330 mg per day in a single dose). Special galenic forms ar e marketed for this indication in France. Biological monitoring (white cell count) is required with ticlopidine. It has not been shown to be of value to investigate the parameters of primary haemostasis (bleedi ng time, platelet function - tests of platelet aggregation). However, under certain circumstances, the advice of a haematologist may be usef ul, especially before an invasive procedure.