The Medical Letter on Drugs and Therapeutics
Issue 1454
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Antithrombotic Drugs
Revised 11/12/14: A paragraph on dipyridamole has been added to the first page (after aspirin).

Antiplatelet drugs are the drugs of choice for prevention and treatment of arterial thrombosis. Anticoagulants are the drugs of choice for prevention and treatment of venous thromboembolism and for prevention of cardioembolic events in patients with atrial fibrillation.


Antiplatelet drugs are used mainly for acute coronary syndrome (ACS), which includes unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI), ST-elevation myocardial infarction (STEMI), and percutaneous coronary intervention (PCI).

ASPIRIN — Aspirin acetylates cyclooxygenase-1, blocking thromboxane synthesis and inhibiting platelet activation and aggregation for the life of the platelet (up to 10 days). Aspirin prophylaxis reduces the incidence of myocardial infarction (MI) and/or death by 15-25% in patients with UA/NSTEMI, STEMI, or ischemic stroke, and in those undergoing PCI or a coronary ... more      

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