Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Atherothrombotic Events
Why the study?
Does clopidogrel plus aspirin reduce the rate of myocardial infarction, stroke, or death from cardiovascular causes compared to aspirin alone in patients with symptomatic atherothrombosis or multiple risk factors?
Population
Patients with symptomatic atherothrombosis or multiple risk factors
Comparison
Clopidogrel plus aspirin vs Aspirin alone
Design
RCT
Authors
Discussion
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Member takes
Implication
No support for adding clopidogrel to aspirin in symptomatic atherothrombosis or risk factors; challenges routine dual therapy beyond acute settings.
Key Points
- To determine whether combining clopidogrel with aspirin is more effective than aspirin alone in preventing major cardiovascular events among patients at risk for atherothrombosis.
- Randomized clinical trial (ClinicalTrials.gov number, NCT00050817) comparing clopidogrel plus aspirin against aspirin monotherapy.
- Included patients with established symptomatic atherothrombosis or multiple cardiovascular risk factors.
- Clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing myocardial infarction, stroke, or cardiovascular death.
- Subgroup analyses revealed a suggestion of benefit from dual therapy in patients with symptomatic atherothrombosis, alongside a suggestion of harm in patients presenting with multiple risk factors alone.
Structured PICO
Does clopidogrel plus aspirin reduce the rate of myocardial infarction, stroke, or death from cardiovascular causes compared to aspirin alone in patients with symptomatic atherothrombosis or multiple risk factors?
P
Population
Patients with symptomatic atherothrombosis or multiple risk factors
I
Intervention
Clopidogrel plus aspirin
C
Comparator
Aspirin alone
O
Outcome
Composite of myocardial infarction, stroke, or death from cardiovascular causescomposite
Adding clopidogrel to aspirin does not significantly reduce major cardiovascular events compared to aspirin alone in a broad population with or at risk for atherothrombosis.
Cite This Study
Bhatt et al. (2006) studied this question.