Two drugs recommended to prevent occlusive vascular events

NICE has updated its 2005 guidance on the use of clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events.

The final guidance recommends the two as treatment options for people who have suffered either an ischaemic stroke, a transient ischaemic attack or a heart attack.

Professor Peter Littlejohns, Clinical and Public Health Director at NICE, says the new guidance “has the potential to have a significant impact on the treatment of many thousands of patients”.

In the UK, it is estimated that 98,000 people have a first ischaemic stroke, as many as 65,000 people have a transient ischaemic attack (TIA) and 146,000 have a heart attack each year.

The guidance recommends clopidogrel as an option for people who have had an ischaemic stroke, who have peripheral arterial disease or who have multivascular disease. It is also recommended for those who have had a heart attack and cannot take aspirin.

Modified-release dipyridamole plus aspirin is advised as an option for people who have had a transient ischaemic attack. For people who have had an ischaemic stroke, modified-release dipyridamole plus aspirin should only be used where clopidogrel is contraindicated or not tolerated.

It is also recommended alone as an option for people who have had an ischaemic stroke or a transient ischaemic attack, but only where treatment with aspirin and clopidogrel is contraindicated or not tolerated.