aspirin + clopidogrel + warfarin

Triple antithrombotic therapy combining aspirin, clopidogrel, and warfarin is used in patients with specific cardiovascular conditions that require both antiplatelet and anticoagulant protection. This combination is most commonly prescribed for patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI) with stent placement or experience acute coronary syndrome (ACS). Each component has a distinct mechanism of action: - **Aspirin**: Irreversibly inhibits cyclooxygenase-1 (COX-1), preventing thromboxane A2 production and platelet aggregation - **Clopidogrel**: Inhibits platelet aggregation by irreversibly blocking the P2Y12 receptor on platelets - **Warfarin**: Vitamin K antagonist that inhibits the synthesis of clotting factors II, VII, IX, and X While this combination provides enhanced antithrombotic protection, it significantly increases bleeding risk. Studies have shown that triple therapy carries a 3- to 6-fold higher risk of bleeding compared to warfarin monotherapy[1][3]. Due to these safety concerns, current clinical practice has shifted toward dual therapy approaches (oral anticoagulant plus a single antiplatelet) in many clinical contexts[2][5].

Other names

triple antithrombotic therapytriple therapy