Is the combination of aspirin and clopidogrel always better than aspirin alone? Or will it be too much of a good thing?

  • V Menon


Confucious was probably the person who once said, “All thingsgood not cheap, all things cheap not good.

”Aspirin is one medicine that tests this aphorism because it isboth cheap and good. Enough evidence exists to show thatlow dose aspirin helps to reduce cardiovascular risk in thosewith coronary heart disease, ischaemic strokes and otherswith established atherosclerotic vascular disease.

In 1998 the results of the Second International Study of InfarctSurvival (ISIS-2)1 were reported. Here aspirin was shown tobe beneficial in the management of patients after an acutemyocardial infarction. This benefit was in addition to the benefitof thrombolysis.

Aspirin is also useful for primary prevention in selected patientsthrough its ability to reduce the risk of heart attacks and strokesin people without any overt cardiovascular disease. ThePhysicians Health Study2 showed that healthy males,particularly those fifty years of age and older, taking 325mg ofaspirin every other day could reduce their risk of myocardialinfarctions significantly. However there is a tendency forincreased gastrointestinal bleeding and haemorrhagic strokesbecause of aspirin and hence such prescriptions need to beindividualised. The Women’s Health Study3 showed thathealthy women who were forty-five years of age and olderand who took 100mg of aspirin every other day had asignificantly lower risk of strokes. (copied from article)


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How to Cite
MenonV. (2008). Is the combination of aspirin and clopidogrel always better than aspirin alone? Or will it be too much of a good thing?. Malaysian Family Physician, 3(2), 2. Retrieved from
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