Key result
Clopidogrel reduces major vascular events ~9% versus aspirin with similar safety.
Why the study?
Aspirin and ticlopidine reduce clinical thrombotic events but carry potentially serious adverse effects, prompting evaluation of the novel thienopyridine clopidogrel.
Does clopidogrel reduce the composite risk of ischaemic stroke, myocardial infarction, or vascular death compared to aspirin in patients with atherosclerotic vascular disease?
Population
19,185 patients with atherosclerotic vascular disease (recent ischaemic stroke, recent MI, or symptomatic PAD)
Comparison
Clopidogrel (75 mg once daily) vs aspirin (325 mg once daily)
Design
Randomised, blinded, international trial
Follow-up
Mean 1.91 years (followed for 1 to 3 years)
Authors
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Supports clopidogrel over aspirin for secondary prevention; reinforces modest superiority with comparable safety in atherosclerotic vascular disease.
Does clopidogrel reduce the composite risk of ischaemic stroke, myocardial infarction, or vascular death compared to aspirin in patients with atherosclerotic vascular disease?
Long-term administration of clopidogrel 75 mg daily is slightly more effective than aspirin 325 mg daily in reducing ischemic events in patients with established atherosclerotic vascular disease, with a comparable overall safety profile.
? et al. (1996) studied this question. Clopidogrel reduced the annual risk of ischaemic stroke, MI, or vascular death by 8.7% compared to aspirin (5.32% vs 5.83%, p=0.043) with similar safety.
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