An appraisal of dual antiplatelet therapy with clopidogrel and aspirin for prevention of cardiovascular events.

Combination antiplatelet therapy, typically with clopidogrel and aspirin, is commonly used for the prevention of cardiovascular events. When used for appropriate indications and duration, its benefits clearly outweigh its risks. However, it is not uncommon for the combination to be used outside of recommended indications or for longer than recommended durations. In these circumstances data are at best unclear and, at worst, indicative of harm. Furthermore, use for one of its indications-prevention of cardiac events after deployment of a coronary stent-is complicated by the type of stent used. This report reviews the evidence surrounding combination antiplatelet therapy with clopidogrel and aspirin, with an emphasis on identifying appropriate indications for and durations of therapy.