Overview
Antiplatelet drugs decrease platelet aggregation and inhibit the formation of thrombi in the arterial circulation. In fast-flowing blood vessels (arteries), thrombi are mainly made of platelets with little fibrin. The opposite is true in the thrombosis of slower-flowing blood vessels (veins), which are richer in fibrin.
The table below summarises the use of antiplatelets in cardiovascular disease.
| Diagnosis | 1st-line option | 2nd-line option |
| Acute coronary syndrome (ACS) treated medically | Lifelong aspirin + 12 months ticagrelor | If aspirin is contraindicated, give lifelong clopidogrel |
| ACS treated with percutaneous coronary intervention (PCI) | Lifelong aspirin + 12 months prasugrel or ticagrelor | If aspirin is contraindicated, give lifelong clopidogrel |
| Peripheral arterial disease (PAD) | Lifelong clopidogrel | If clopidogrel is contraindicated, give lifelong aspirin |
| Transient ischaemic attack (TIA) | Lifelong clopidogrel | If aspirin is contraindicated, lifelong aspirin + lifelong modified-release dipyridamole |
| Ischaemic stroke | Lifelong clopidogrel | If aspirin is contraindicated, lifelong aspirin + lifelong modified-release dipyridamole |
