Medicines known as antiplatelets are among the most widely used in the world, primarily because aspirin is one of them. Three newer antiplatelets – sometimes called “superaspirins” – are available. They are Aggrenox, ticlopidine (Ticlid), and clopidogrel (Plavix).

These medicines are used to lower the risk of heart attack and stroke under a variety of circumstances. They are highly effective in doing so. For example, in people who have had a heart attack, they can lower the risk of a repeat attack by about 35 percent. The antiplatelets are also used to treat people who have artery blockages in their legs.

The antiplatelet medicines work by decreasing blood clotting, which evidence now shows is directly linked to heart attack and stroke risk.

 Taking the evidence for effectiveness, safety, side effects, and cost into account, we have chosen the following as Consumer Reports Best Buy Drugs for people in these clinical circumstances:

• Aspirin – if you have risk factors for heart attack and stroke (such as high blood pressure, smoking, diabetes, and/or high cholesterol) but have not been diagnosed with heart disease or had a heart attack, stroke, or mini-stroke (also known as a transient ischemic attack, or TIA)
• Aspirin – if you have been diagnosed with heart disease and so-called “stable” angina
• Clopidogrel (Plavix) – if you have been diagnosed with heart disease, have stable angina but can not take aspirin
• Aspirin + clopidogrel (Plavix) - if you have what is known as “unstable” angina or acute coronary syndrome, have had a heart attack, or have had angioplasty and a stent implanted in the last year
• Aggrenox - if you have had a stroke or mini-stroke

It’s not possible to choose a Best Buy drug for people with artery blockages in their legs. Too few studies have compared the antiplatelet drugs in the treatment of this condition. However, your doctor is likely to start treating you with aspirin if you have this condition.

Be sure to ask your doctor about generic clopidogrel, although availability of this drug is in limbo due to patent litigation.