Drug evaluation of clopidogrel in patients with ischemic stroke

Clopiclogrel is an effective antiplatelet medication used for the secondary prevention of ischemic events in patients with various cardiovascular, cerebrovascular and peripheral vascular disease conditions. The objective of this paper is to discuss the role of clopiclogrel in ischernic stroke patients and to review the existing data from randomized trials supplemented by pilot and mechanistic studies that supports these indications for its use. An analysis of the mechanism of action and pharmacology of clopiclogrel is provided. After Phase III trials, such as the CAPRIE (Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events) and MATCH (Management of Atherothrombosis with Clopiclogrel in High-risk patients) trials, the role of clopiclogrel in secondary prevention is well defined. The role of clopiclogrel in acute ischemic stroke and neurointerventional procedures is evolving based on new pilot trials. At present, there is insufficient data to recommend the use of clopiclogrel in acute ischemic stroke. Clopiclogrel may be a valuable alternative to aspirin. However, more studies are required to assess the role of clopiclogrel in selected patient groups with respect to acute ischemic stroke.