[Antiplatelet agents (inhibitors of platelet function) orally administered. Bases for their practical use in coronary artery disease].

Long-term antithrombotic therapy, administered orally, is necessary in all patients with symptomatic coronary artery disease; the most commonly used drugs are those which inhibit platelet aggregation. Aspirin and ticlopidine do not act on the same point of platelet function. They have the common property of inhibiting platelet function irreversibly and of partially inhibiting platelet aggregation. Flurbiprofenee acts like aspirin on thromboxane synthesis but the effect is reversible in 24 hours. The full effect of ticlopidine is only observed after several days' administration. The association of aspirin and ticlopidine is used over short periods after implantation of a stent. The dosage of ticlopidine is 2 tablets per day; that of aspirin is not well established (100 to 330 mg per day in a single dose). Special galenic forms are marketed for this indication in France. Biological monitoring (white cell count) is required with ticlopidine. It has not been shown to be of value to investigate the parameters of primary haemostasis (bleeding time, platelet function--tests of platelet aggregation). However, under certain circumstances, the advice of a haematologist may be useful, especially before an invasive procedure.