An Audit of Prescribing Practice for Clopidogrel in Primary Care

JSMSCARDIOLOGY & RESPIRATORY MEDICINEAn Audit of Prescribing Practice for Clopidogrel in Primary CareTammy LoKing’s College London School of Medicine, United KingdomIntroductionClopidogrel (Plavix®) is a powerful antiplatlet drug. Its usage in combina- Corresponding authortion with aspirin has become the standard of care in management of a wide Tammy Lovariety of cardiovascular diseases. Its molecular mechanism of action is in e: tammy.lo@kcl.ac.ukblocking interaction between adenosine diphosphate and the G-protein coupled P2Y 12 purinergic receptor located on the surface of platelet cells. Conflicts of interestNone declaredNICE guidelines [1, 2] direct the duration of clopidogrel usage in the secondary prophylaxis of atherothrombotic events following:1) a recent ACS episode2) a recent myocardial infarction3) a recent occlusive vascular event4) with established peripheral vascular disease5) coronary artery bypass grafting (CABG).The duration of aspirin and clopidogrel dual therapy is recommended in the NICE guidelines.12 months post NSTEMIAt least four weeks post STEMIFour weeks post-CABG surgeryThe British Cardiovascular Intervention Society [3] recommends dual therapy prior and following a percutaneous coronary inter-vention (one month following bare metal stent insertion and 12 months following drug-eluting stent insertion). Clopidogrel/aspi-rin dual therapy is limited by an increased risk of bleeding. Furthermore, clopidogrel ...