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Based on efficacy and safety, clopidogrel was recommended as the drug of choice for patients with established peripheral arterial disease; aspirin or clopidogrel should be considered in patients with prior myocardial infarction (with clopidogrel favored for patients who have had a recurrent event while on aspirin or in whom aspirin is contraindicated); aspirin or clopidogrel should be considered as first\u2010line treatment in patients with prior ischemic (nonhemorrhagic) stroke\u2010however, clopidogrel is the favored drug in patients in whom other antiplatelet drugs are either contraindicated or who have had recurrent events while on therapy.<\/jats:p><jats:p><jats:italic>Conclusions:<\/jats:italic> Myocardial infarction, ischemic stroke, and peripheral arterial disease are all clinical manifestations of the same underlying disease process (atherosclerosis), with thrombus formation on the disrupted atherosclerotic plaque (atherothrombosis) being a common precipitating factor of ischemic events in patients suffering from these disorders. An evidence\u2010based approach was used to develop a practice guideline, based on available published evidence, for the appropriate utilization of antiplatelet agents (aspirin, ticlopidine, or clopidogrel). These guidelines may be of use to multidisciplinary teams wishing to create or update clinical guidelines or clinical pathways which address the care of patients with atherosclerotic vascular disease. New antiplatelet agents such as clopidogrel may be more effective and associated with lower risk of selected adverse effects (such as gastrointestinal distress, gastrointestinal hemorrhage, and neutropenia) than those previously used to prevent thrombus formation in the setting of atherosclerotic arterial disease. Combination antiplatelet therapy is being evaluated as an option for those patients who experience recurrent events on a single antiplatelet agent.<\/jats:p>","DOI":"10.1002\/clc.4960220905","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T02:44:30Z","timestamp":1233715470000},"page":"559-573","source":"Crossref","is-referenced-by-count":25,"title":["Antiplatelet therapy in the prevention of ischemic vascular events: Literature review and evidence\u2010based guidelines for drug selection"],"prefix":"10.1002","volume":"22","author":[{"given":"Randall M.","family":"Zusman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James H.","family":"Chesebro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Comerota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph R.","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward K.","family":"Massin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Raps","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip A.","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043798-199412000-00009"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90493-6"},{"key":"e_1_2_1_4_2","first-page":"1","article-title":"Detailed diagnoses and procedures, National Hospital Discharge Survey, 1995","volume":"130","author":"Graves E","year":"1997","journal-title":"Vital Health Stat"},{"key":"e_1_2_1_5_2","first-page":"83","article-title":"Current estimates from the National Health Interview Survey, 1994. 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