This analytical paper presents the modern evidence on the dual antiplatelet therapy in ST-elevation myocardial infarction. A possible replacement of one dual therapy components – clopidogrel – with newer, more effective agents, such as ticagrelor and prasugrel, is discussed. For each of the latter medications, the existing evidence base is presented, together with the results of the studies comparing clopidogrel to ticagrelor and prasugrel. It is emphasized that only ticagrelor could potentially replace clopidogrel, and only as a part of the strategy based on primary percutaneous coronary intervention. For other strategies, such as thrombolytic therapy, pharmacoinvasive approach, and impossibility of reperfusion, clopidogrel remains a nonreplaceable element of the dual antiplatelet treatment in patients with ST-elevation myocardial infarction. © 2013, Silicea-Poligraf. All rights reserved.