Key result
Fixed-dose aspirin and clopidogrel is safe in CAD with an ~8% cardiovascular hospitalization rate.
Why the study?
Assessing ischemic burden and bleeding risk is crucial in DAPT selection and duration, prompting prospective clinical evaluation of fixed-dose ASA 75 mg plus clopidogrel 75 mg.
Does fixed-dose combination dual antiplatelet therapy (aspirin 75 mg + clopidogrel 75 mg) prevent cardiovascular events and bleeding in patients with acute or chronic coronary syndrome?
Cohort (n=1,500)
Yes
Does fixed-dose combination dual antiplatelet therapy (aspirin 75 mg + clopidogrel 75 mg) prevent cardiovascular events and bleeding in patients with acute or chronic coronary syndrome?
Fixed-dose combination of aspirin 75 mg and clopidogrel 75 mg appears effective and safe with low rates of major bleeding and ischemic events in patients with acute or chronic coronary syndromes.
Answers are grounded in this paper and cite their sources.
May support fixed-dose DAPT in CAD; hypothesis-generating, requires RCTs before practice change.
Background Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued. Objectives The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study. Methods A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%. Results Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.
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Öz et al. (2024) conducted a cohort in Coronary Artery Disease (Acute or Chronic Coronary Syndrome) (n=1,500). Fixed-dose combination dual antiplatelet therapy (Aspirin + Clopidogrel) was evaluated on Hospitalization for any reason. Fixed-dose combination therapy of aspirin 75 mg and clopidogrel 75 mg was effective and safe in patients with coronary artery disease, with a 7.9% rate of cardiovascular hospitalization and 0.6% rate of major bleeding.
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