{blacktriangledown}Clopidogrel and acute coronary syndrome

doi:10.1136/dtb.2002.40641

Drug and Therapeutics Bulletin 2002;40:41-42; doi:10.1136/dtb.2002.40641

${blacktriangledown}$ Clopidogrel and acute coronary syndrome

Relevant BNF section: 2.9

${blacktriangledown}$ Clopidogrel (Plavix - Sanofi-Synthelabo & Bristol-MyersSquibb) blocks platelet aggregation through an action distinctfrom that of aspirin. In the UK, it is licensed for the secondaryprevention of atherosclerotic events and for this, we concluded3 years ago that clopidogrel "appears to offer no worthwhileadvantage over aspirin".¹ After publication of the CURE (Clopidogrelin Unstable angina to prevent Recurrent Events) trial,² whichassessed adjunctive use of clopidogrel with aspirin in patientswith acute coronary syndrome without ST-segment elevation (unstableangina or non-Q wave infarction), clopidogrel was hailed inthe lay media as "the biggest breakthrough in 20 years".³ Dothe CURE study results warrant the use of clopidogrel in patientswith acute coronary syndrome without ST elevation (currentlyan unlicensed indication)?