Antithrombotic therapy in unstable angina and after coronary interventions

Aspirin and Heparin: In several studies aspirin has been found to be very e ffective in unstable angina pectoris reducing fatal and non-fatal myocardia l infarction by 50-70% Unfortunately the optimal dose of aspirin is still a n open question. Whereas heparin alone shows only a weak effectiveness the combination of aspirin and heparin is superior to aspirin alone and is stil l the basis of antithrombotic therapy in unstable angina. Ticlopidine and Clopidogrel: Experience with thienopyridine derivatives in unstable angina is limited. Ticlopidine has been found to be superior to as pirin alone. Data with the combination of clopidogrel and aspirin should be available soon. Therapeutic Recommendation after Coronary Intervention: Both, ticlopidine a nd clopidogrel have been found to be very effective in preventing coronary- stent thrombosis when combined with aspirin. Meanwhile ticlopidine has been widely substituted by clopidogrel due to the better safety profile of the latter one. 75 mg clopidogrel daily combined with aspirin is recommended fo r at least 4 weeks after coronary stenting.