Clopidogrel and aspirin combination for MI

Clopidogrel and aspirin combination is very effective in the management of MI (myocardial infarction). Clopidogrel is licensed for the prevention of ischemic events in patients with a history of symptomatic ischemic disease. Clopidogrel, in combination with low dose aspirin, is also licensed for acute coronary syndrome (myocardial infarction, MI) without ST segment elevation; in these circumstances the combination is given for at least 1 month but usually no longer than 9-12 months. However, long term routine use of clopidogrel with aspirin increases the risk of bleeding and the evidence of benefit of such use is not compelling. A low dose of aspirin is used for the secondary prevention of cardiovascular diseases.

Aspirin is an irreversible inhibitor of platelet cyclooxygenase activity and thereby interferes with platelet activation. Chronic administration of 75 to 325 mg orally per day has been shown to reduce coronary events in asymptomatic adult men, patients with chronic stable angina, and patients with or who have survived unstable angina and myocardial infarction. Administration of this drug should be considered in all patients with IHDin the absence of gastrointestinal bleeding, allergy, or dyspepsia. Clopidogrel (300 mg loading and 75 mg/d) is an oral agent that blocks ADP receptor–mediated platelet aggregation. It provides the same benefits as aspirin, if not better, particularly if aspirin causes the side effects listed above. Clopidogrel with aspirin can improve coronary outcomes when given to patients for 1 year after an episode of unstable angina but with some increase in the risk of bleeding. This increased risk is improved when the dose of aspirin is reduced.
Side effects of clopidogrel and aspirin combination are bleeding manifestations, nausea, vomiting, hypotension, bradycardia, chest pain, etc.