Aspirin and Clopidogrel: Efficacy, Treatment, and Resistance in Coronary Artery Disease

Oral antiplatelet therapy is a key element of the continuously evolving treatment of acute coronary syndromes. As part of this evolution, resistance to oral antiplatelet therapy has emerged as a new challenge adversely affecting patients’ clinical risk and outcome. This review addresses the role of two oral antiplatelet therapy agents, aspirin and clopidogrel, their mechanism of action, and the evidence supporting their use in the setting of coronary artery disease. Unfortunately, clinically relevant resistance to aspirin and clopidogrel exists. Resistance may indicate a higher risk for major adverse events. An established safe and reliable treatment alternative is lacking at this point; further research is needed to evaluate the efficacy of any alternative treatments that can be offered to decrease cardiovascular risk and improve clinical outcomes.