Clopidogrel: A selective inhibitor of platelet ADP receptors

Platelets play a key role in the development of ischemic complications in t he arterial circulation. Antiplatelet therapy has proven effective in the t reatment and prevention of ischemic events. Numerous clinical studies have confirmed the therapeutic efficacy of aspirin to such a point that this ant iplatelet agent has become the gold standard in clinical practice. Clopidog rel is a thienopyridine compound that inhibits platelet aggregation by sele ctively binding to adenylate cyclase-coupled ADP receptors. Results of a la rge, double-blind, randomized study (CAPRIE) confirm that administration of clopidogrel to patients with atherosclerotic vascular disease is more effe ctive than aspirin in reducing the combined risk of ischemic stroke, myocar dial infarction or vascular death. The present article highlights the impor tance of activation of platelets through ADP receptors and reviews the phar macology and clinical studies of clopidogrel, a selective inhibitor of thes e mechanisms. (C) 2000 Prous Science. All rights reserved.