October 25, 2004Archives of Internal Medicine
Comparative Benefits of Clopidogrel and Aspirin in High-Risk Patient Populations
Why the study?
Does clopidogrel improve outcomes compared to aspirin alone in high-risk cardiovascular patients?
Population
Cardiovascular patients from the CAPRIE and CURE trials, with a focus on high-risk subgroups.
Comparison
Clopidogrel vs Aspirin alone
Design
Review
Authors
Discussion
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Member takes
Implication
May support clopidogrel in high-risk subgroups; hypothesis-generating and requires dedicated trials before changing practice.
Structured PICO
Does clopidogrel improve outcomes compared to aspirin alone in high-risk cardiovascular patients?
P
Population
Cardiovascular patients from the CAPRIE and CURE trials, with a focus on high-risk subgroups (previous coronary bypass surgery, history of >1 ischemic event, multiple vascular beds involvement, diabetes, hypercholesterolemia, PCI, high TIMI score, prior revascularization).
I
Intervention
Clopidogrel (alone in CAPRIE, combined with aspirin in CURE)
C
Comparator
Aspirin alone
O
Outcome
Total event rates, absolute risk reduction, relative risk reduction, and number needed to treat
High-risk cardiovascular patients derive enhanced benefit from clopidogrel compared to aspirin alone.
Cite This Study
Hirsh et al. (2004) studied this question.