Dual Antiplatelet Therapy with Aspirin and Clopidogrel

Guideline-Recommended Uses

• The American College of Cardiology recommends dual antiplatelet therapy with aspirin 81mg plus clopidogrel 75mg daily for at least 12 months after coronary stent placement, for both bare-metal stents and drug-eluting stents 1, 2, 3
• The American Heart Association recommends clopidogrel 75mg daily combined with aspirin for at least 12 months in all patients with acute coronary syndromes (with or without PCI) 2, 3

Chronic Coronary Disease Management

• The American Heart Association recommends aspirin 75-162mg daily indefinitely after the initial 12-month period post-ACS or stent placement 4
• The American Heart Association recommends clopidogrel 75mg daily as an alternative for patients who are intolerant of or allergic to aspirin 4

Important Safety Considerations

• The American College of Cardiology suggests using 81mg per day of aspirin in preference to higher maintenance doses when combined with clopidogrel after PCI 2, 3
• The American Heart Association recommends careful monitoring when using concomitant warfarin or other anticoagulants with dual antiplatelet therapy, with lower aspirin doses (75-81mg) and INR 2.0-2.5 5, 6
• The American College of Cardiology recommends earlier discontinuation of dual antiplatelet therapy after the minimum recommended duration for patients at high risk of bleeding 2, 3