[Long-term use of oral antiplatelet therapy: from studies to practice]

Antiplatelet treatment (platelet aggregation inhibitors) is essential in cardiovascular medicine today. Aspirin and, more recently, clopidogrel are among the most important treatments of cardiovascular diseases. Although the benefit/risk ratio is generally favorable as secondary prevention, and justifies the treatment, it is less so in primary prevention and indeed, sometimes difficult to establish. Although the combination of two treatments seems attractive, it has been shown effective only for some indications. The principal risk of an antiplatelet treatment that inhibits clotting is bleeding, and the risk almost doubles when two treatments are combined. New platelet aggregation inhibitors, undoubtedly more efficacious, but also more likely to induce bleedings, will probably emerge.