Doses ,75 mg have less proven benefit.716,723 Aspirin is relatively contraindicated in patients with known allergies to nonsteroidal antiinflammatory drugs and in patients with the syndrome of asthma, rhinitis, and nasal polyps. Clopidogrel, a thienopyridine derivative, inhibits platelet aggregation via selective and irreversible inhibition of the adenosine diphosphate P2Y12 receptor. Clopidogrel 75 mg has been compared with aspirin 325 mg in patients with previous MI, stroke, or symptomatic PAD in the prospective, randomized CAPRIE (Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events) study.718 Although clopidogrel demonstrated superiority over aspirin in the secondary pre- vention of MI and death in this group of patients, the magnitude of difference was small. Because no additional trials comparing aspirin and clopidogrel in patients with SIHD have been conducted, clopidogrel remains an accept- able alternative agent to aspirin. In certain high-risk patients, combined treatment with aspirin and clopidogrel has been shown to be beneficial. In the CURE (Clopidogrel in Unstable Angina to Prevent Recurrent Events) study, patients with a recent NSTEMI were randomized to clopidogrel plus aspirin (300 mg/d and 75 mg/d) for an average of 9 months. These patients experienced fewer deaths from cardiovascular causes, nonfatal MIs, and strokes than did patients receiving placebo plus aspirin (75 to 325 mg/d).724 Similar results were found in the CREDO (Clopidogrel for Reduction of Events During Observation) study. 