[Anti-aggregating agents: for which patients?].

Platelets are at the center of the phenomenon leading to thrombus formation; they also occupy an important place in the process leading to the development of the atheromatous plaque: these two actions justify the interest taken in anti-platelets medications in cardiac pathology. In spite of the uncertainties remaining about this very controverted subject, it seems that the prescription of an anti-platelets medication is legitimate in all situations where there is a danger of formation or extension of a thrombus. Within the scope of coronary pathology, the most recent trials show a favorable action of anti-platelets medications in unstable angina, aorto-coronary by-pass or the secondary prevention of myocardial infarction. In addition, it is recommended to start the treatment as quickly as possible before surgery, as far as cardiac surgery is concerned. Finally, concerning the dispute about the optimal dose of aspirin, the current tendency is to advocate a moderate dosage.