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However, its efficacy has been challenged in the recent past by studies suggesting variable individual responsiveness and by new, more potent competitors, such as prasugrel and ticagrelor. Is there any dark side of the moon? And what will be the future role of ticagrelor, when approved for routine clinical practice? We hereby concisely summarize the scope of this clinical choice, providing arguments in favor and against each of the three antiplatelet agents: clopidogrel, prasugrel, and ticagrelor. The crucial role of clopidogrel in association with aspirin in patients with acute coronary syndromes ACS is testified by the fact that this drug is among the best selling drugs worldwide, together with statins, proton-pump inhibitors, and angiotensin-II receptor antagonists.

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