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Often a combination of aspirin plus an ADP/P2Y inhibitor [7] (such as clopidogrel, prasugrel, ticagrelor, or another) is used to obtain greater effectiveness than with either agent alone. This is known as "dual antiplatelet therapy" (or DAPT ).
The resistance of clopidogrel has emerged through the years and become a great concern for the therapy of patients with ACS or undergoing PCI. Clopidogrel resistance is reported to vary from 4-44% between different populations and ethnic groups. Patients who are exposed to clopidogrel resistance display lower activity of platelet inhibition due ...
Clopidogrel, sold under the brand name Plavix among others, is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. [10] It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent (dual antiplatelet therapy). [10]
Patients are often started on an antiplatelet (e.g. aspirin, clopidogrel) or occasionally an anticoagulant (e.g. warfarin) to reduce the risk of future strokes. Where VBI is causing reproducible symptoms due to stenosis, lifestyle modification to avoid provoking factors (e.g. dehydration, standing rapidly from sitting or lying) may reduce symptoms.
The TIMI risk score can identify high risk patients in ST-elevation and non-ST segment elevation MI ACS [30] [31] and has been independently validated. [32] [33] Based on a global registry of 102,341 patients, the GRACE risk scoreestimates in-hospital, 6 months, 1 year, and 3-year mortality risk after a heart attack. [34]
A high score corresponds to a greater risk of stroke, while a low score corresponds to a lower risk of stroke. The CHADS 2 score is simple and has been validated by many studies. [ 2 ] In clinical use, the CHADS 2 score (pronounced "chads two") has been superseded by the CHA 2 DS 2 -VASc score ("chads vasc" [ 3 ] ), which gives a better ...
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[1] [2] Its usefulness was questioned in a 2015 review as it was not found to separate those who are at low from those who are at high risk of future problems. [3] A high score correctly predicted 87% of the people who did have a stroke in the following 7 days but also many people who did not have problems.