Antiplatelet treatment should be considered for all patients diagnosed with stable angina, after considering the patients risk of bleeding and comorbidities. The aim of treatment is to prevent blood clots by preventing platelet aggregation.

Antiplatelet treatment will normally be low dose aspirin (75mg daily). Clopidogrel is a suitable alternative for patients unable to tolerate aspirin.

Patients previously diagnosed with stroke, transient ischaemic attack (TIA) or peripheral arterial disease (PAD) should already be treated with clopidogrel and they should continue to take this rather than switching to aspirin.

Patients prescribed aspirin should be given advice on minimising gastro-intestinal bleeding. This would include checking for additional medicines that increase the risk of GI bleeds, taking the aspirin after food, providing advice on sensible levels of alcohol consumption and stopping smoking.

Patients at high risk of GI bleed should be co-prescribed a proton pump inhibitor (PPI) such as lansoprazole, omeprazole or pantoprazole for gastroprotection.¹³

¹³ Clinical Knowledge Summaries: Antiplatelet treatment. NICE. http://cks.nice.org.uk/antiplatelet-treatment. Revised June 2018.