The FDA indication for<unk>  is reduction of the rate of cardiovascular death, myocardial infarction (MI), and stroke in people with acute coronary syndrome or history of myocardial infarction.<unk>  is used for the prevention of thrombotic events (for example stroke or heart attack) in different categories of patients. The drug is combined with acetylsalicylic acid unless the latter is contraindicated. The PLATO trial concluded superiority of<unk>  compared to clopidogrel in reducing the rate of death from vascular causes, MI, and stroke in patients presenting with acute coronary syndromes. A post-hoc subgroup analysis of the PLATO trial suggested a reduction in total mortality with<unk>  compared to clopidogrel in patients with non-ST elevation acute coronary syndrome. However, this finding should only be considered exploratory as it was not a primary endpoint of the PLATO trial. Subsequent studies have also been underpowered in evaluating total mortality benefits with<unk> . Further studies are required to provide statistically significant outcomes for total mortality with<unk>  before this can be applied convincingly to clinical practice. According to ESC 2017 guidelines, dual antiplatelet therapy (DAPT) with<unk>  in combination with acetylsalicylic acid (Aspirin) is the preferred treatment in patients with acute coronary syndrome with or without ST segment elevation, irrespective of the initial treatment strategy – invasive or non-invasive (IB level of evidence) however if there is a plan for percutaneous coronary intervention (PCI), administration of thrombolysis or the presence of some other patient factors (e.g. high bleeding risk) other antiplatelet agents are recommended. The 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy provides similar recommendations, although with a lower level of evidence (IIaB). Furthermore, the 2017 ESC Focused Update on Duration of Dual Antiplatelet Therapy allows physicians to administer<unk>  to patients with stable coronary artery disease undergoing percutaneous coronary intervention after taking thrombotic and haemorrhagic risk into consideration. In people with non-cardioembolic minor ischaemic stroke or high-risk TIA,<unk>  monotherapy did not reach statistical significance in reducing the composite of stoke, myocardial infarction or death compared to aspirin despite numerical reduction.<unk>  plus aspirin was superior to aspirin alone in reducing the composite of stroke or death at 30 days in the large THALES randomised controlled trial; however, at an increased risk of severe bleeding. Although supporting the role of short-term dual antiplatelet therapy post minor ischaemic stroke or high-risk TIA, there are currently no published head-to-head comparisons of<unk>  plus aspirin versus the current standard-of-care in this cohort of clopidogrel plus aspirin. Further studies addressing this (including the results of the currently ongoing CHANCE-2 trial) are required to clarify the role of<unk>  in clinical practice post stroke. In trials of both<unk>  monotherapy and<unk>  plus aspirin versus aspirin alone for minor ischaemic stroke or high-risk TIA, the subgroup of patients with ipsilateral stenosis of intracranial or extracranial arteries had a higher absolute risk of recurrent stroke and greater magnitude of absolute benefit than the subgroup without ipsilateral stenosis. However, these subgroup analyses were hypothesis-generating only. A study compared<unk>  and clopidogrel in participants with acute coronary syndrome (PLATO Trial) showed that participants treated with<unk>  had a lower risk of infection-related deaths. The Targeting Platelet-Leukocyte Aggregates in Pneumonia With<unk>  (XANTHIPPE) study showed improvement in lung function in participants hospitalized for pneumonia using<unk> .
Ticagrelor
Clopidogrel
Ticlopidine
Prokarin
Rivaroxaban
Eptifibatide
Apixaban
Palladin