Prescribing patterns of antiplatelet drugs in patients with cardiovascular and cerebrovascular diseases

References

1. for its effectiveness in preventing thrombotic events. Conversely, clopidogrel and aspirin AV are the least used, likely due to limited efficacy or safety concerns in certain populations. The overlap of comorbidities adds another layer of complexity, as 65% of patients suffer from additional illnesses such as hypertension, diabetes, or hyperlipidemia, compared to only 35% without such conditions. This indicates the strong interconnection between cardiovascular and cerebrovascular diseases, emphasizing the importance of comprehensive management strategies addressing multiple risk factors simultaneously (Kendir et al., 2018). 12 Special considerations are also necessary when dealing with comorbid conditions. Patients with diabetes mellitus face increased risks of both thrombotic and bleeding events, requiring tailored therapy and careful monitoring of drugs like ticagrelor and clopidogrel (Vazzana et al., 2012). 13 Similarly, those with chronic kidney disease or acute kidney injury need adjusted dosing and close renal monitoring to balance efficacy and safety (Saeed et al., 2024). 14 COPD patients are generally managed with aspirin, as ticagrelor may exacerbate dyspnea. In hypothyroidism, thrombosis and bleeding risks remain high, necessitating cautious antiplatelet use. In chronic liver disease with associated pruritus, aspirin is used with regular renal monitoring when CKD is also present. Infections further complicate management by inducing a hypercoagulable state, where aspirin is again preferred to avoid respiratory side effects of ticagrelor. Pulmonary edema and pleural effusion, both often linked to underlying cardiovascular pathology, are managed primarily with aspirin, though clopidogrel or prasugrel may be considered for pleural effusion. Taken together, these findings highlight the importance of individualized treatment approaches. Clinical decisions regarding antiplatelet therapy must consider patient-specific factors such as sex, age, comorbidities, and geographical setting. The high prevalence of multimorbidity reinforces the need for comprehensive and integrated care models that go beyond single-disease management. Moreover, the results underscore the necessity of future longitudinal studies to evaluate the long-term safety and effectiveness of Choudhary et al. / Indian Journal of Pharmacy and Pharmacology 2025;12(3):167–175 175 various antiplatelet combinations in diverse patient groups, especially those at very high risk of both cardiovascular and cerebrovascular complications (Kassymova et al., 2025). 15
2.  Conclusion This study shows how our tertiary care setting’s antiplatelet prescribing practices relate to current evidence-based practice and suitable therapeutic individualisation. Clinical recommendations have been effectively implemented into regular practice, as seen by the common usage of aspirin, the strategic use of dual antiplatelet medication, and disease-specific prescribing techniques. These results support our overarching objective of offering patients evidence-based care that improves treatment results via focused treatments and effective therapyapproaches. The knowledge obtained through this research serves as a basis for ongoing quality improvement in the treatment of cardiovascular and cerebrovascular diseases, and, in addition, an increasing amount of data supports targeted antiplatelet medication strategies. By understanding current prescribing patterns and their clinical rationale, healthcare providers can continue to refine their therapeutic approaches and ensure optimal patient outcomes in the evolving landscape of antiplatelet therapy.
3.  Ethical No. IEC/PIMS/24/10
4.  Authors Contribution
5. Dr. Sumit Choudhary: Data Collection, Table and R.O.L.
6. Dr. Anurag Kumar: Data Collection, Manuscript writing, Data evaluation by SPSS.
7. Dr. Ravi Shankar Dwivedi: Evaluator, Data Correction.
8. Dr. Tushar Arora: Supervisior, Data Evaluator.
9.  Source of Funding None
10.   Conflict of Interest None References
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25. Mansurova J, Kassymova A, Kozhabayeva A, Karazhanova L. (2025). Personalized antiplatelet therapy in a post-PCI patient with high bleeding risk. Signa Vitae , 21(3), 114–119. https://doi. org/10.22514/sv.2025.044 Cite this article: Choudhary S, Kumar A, Dwivedi RS, Arora T. Prescribing patterns of antiplatelet drugs in patients with cardiovascular and cerebrovascular diseases. Indian J Pharma Pharmacol. 2025;12(3):167–175