Medications

Anti-Platelet and Anticoagulant Drugs

Anti-clotting drugs that inhibit or break up blood clots are used at every stage of heart disease. They are generally classified as either anti-platelets or anticoagulants. All anti-clotting therapies carry the risk of bleeding, which can lead to dangerous situations, including stroke.

Aspirin. Aspirin is known as a nonsteroidal anti-inflammatory drug (NSAID). It stops blood platelets, which are major clotting factors, from sticking together to form a blood clot. Aspirin therapy is extremely beneficial for patients with coronary artery disease or history of stroke.

A daily low-dose aspirin (75 - 81 mg) is usually the first choice for preventing heart disease or stroke in high-risk individuals. Aspirin can reduce the risk of heart attack and ischemic stroke. However, prolonged use of aspirin can increase the risks for stomach bleeding. A doctor needs to consider a patient’s overall medical condition and risk factors for heart attack before recommending aspirin therapy.

In general, daily low-dose aspirin is recommended for prevention of heart disease for the following people who have never had a heart attack or stroke:

• Women age 55 - 79. (Women who are younger than age 55 should not take aspirin for primary prevention.)
• Men age 45 - 79 years should take aspirin if the chances for preventing stroke or heart attack outweigh the risks of gastrointestinal bleeding. Men younger than age 45 should not take aspirin for primary prevention.
• For women and men age 80 years or older, it is not clear if the benefits of aspirin for heart protection outweigh the risks for bleeding.

Thienopyridines (Clopidogrel and Prasugrel). Thienopyridines are anti-platelet drugs. Clopidogrel (Plavix) is the standard thienopyridine. Prasugrel (Effient) is a new thienopyridine.

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Review Date: 05/05/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)