Anti Platelet in Coronary Artery Disease :

What Should We Do And Where Are We Now in

Dual AntiPlatelet Therapy ?
Dewi Hapsari Suprobo, MD, FIHA
 I do not have conflict interest
 ASPIRIN

• Aspirin remains the

cornerstone of
pharmacological
prevention of
arterial thrombosis
• The optimal risk
and benefit ratio
appears to be
achieved with an
aspirin dosage of
75–150 mg/day
TICLOPIDINE

• Ticlopidine is first
generation
thienopyridine (1978).
• Ticlopidine has rare but
potentially fatal side
effects (aplastic
anemia, neutropenia
and thrombotic
thrombocytopenic
purpura) requiring
routine hematological
monitoring
CLOPIDOGREL

• Clopidogrel is a
second generation
thienopyridine
(1997).
• Clopidogrel
proposed as a
second-line
treatment,
especially for
aspirin-intolerant
CVD patients
Clopidogrel → Delayed
Onset of Action
Comparison of P2Y12 Inhibitors
• treatment indication (stable coronary artery
disease or ACS)
• type of intervention (PCI, coronary artery bypass
graft or medical treatment alone without
revascularisation)
• on the type of device used in the case of PCI
(drug-eluting stent [DES], bare-metal stent [BMS],
bioresorbable vascular scaffold [BVS], drug-
eluting balloon [DEB])
• estimated bleeding risk
Duration : What Does The Guidelines Say ?
-Matur Nuwun-