Effects of Clopidogrel in Addition to Aspirin in Patients with Acute Coronary Syndromes without ST-Segment Elevation

Clopidogrel plus aspirin had clinical benefit beyond that of aspirin alone, but there was an increased risk of bleeding. Thrombosis caused by a ruptured or eroded atherosclerotic plaque is the usual underlying mechanism of acute coronary syndromes. 1 Aspirin and heparin reduce the risk of death from cardiovascular causes, new myocardial infarction, and recurrent ischemia, 2 , 3 but there is still a substantial risk of such events in both the short term and the long term. Intravenous glycoprotein IIb/IIIa receptor blockers have been shown to reduce the incidence of early events, mainly among patients who are treated according to an invasive strategy, 4 , 5 but long-term oral therapy with glycoprotein IIb/IIIa receptor blockers is not beneficial and may even increase mortality. 6 Similarly, . . .