Based on the level of risk, most patients are either started on aspirin or
Warfarin (Coumadin). Clopidogrel (
Plavix) is an anti-platelet agent and acts via a different mechanism than coumadin does (coagulation pathway). Adding Clopidogrel to aspirin is a guideline that holds a Class 2b (see below) recommendation, and usually considered in those in which Warfarin is unsuitable due to patient preference or physician's assessment on a patient's ability to safely sustain anticoagulation.