Key result
Clopidogrel reduced the annual risk of ischemic stroke, myocardial infarction, or vascular death compared to aspirin (5.33% vs 5.83%; RRR 8.7%, 95% CI 0.3-16.5, p=0.043).
Why the study?
Does clopidogrel reduce the composite of ischemic stroke, myocardial infarction, or vascular death compared to aspirin in patients at risk of ischemic events?
Population
19,185 patients at risk of ischemic events
Comparison
Clopidogrel vs Aspirin
Design
Review, randomized, blinded
Authors
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May support clopidogrel preference in select high-risk patients; leaves open need for contemporary randomized confirmation.
RCT (n=19,185)
blinded
randomized
Yes
Does clopidogrel reduce the composite of ischemic stroke, myocardial infarction, or vascular death compared to aspirin in patients at risk of ischemic events?
Effect estimate: RRR 8.7% (95% CI 0.3-16.5)
Absolute Event Rate: 5.33% vs 5.83%
p-value: p=0.043
Clopidogrel is slightly more effective than aspirin in reducing the risk of ischemic events in at-risk patients, with a different adverse effect profile.
Paciaroni et al. (1999) conducted an RCT in Patients at risk of ischemic events (n=19,185). Clopidogrel vs. Aspirin was evaluated on outcome cluster of ischemic stroke, myocardial infarction, or vascular death (RRR 8.7%, 95% CI 0.3-16.5, p=0.043). Clopidogrel reduced the annual risk of ischemic stroke, myocardial infarction, or vascular death compared to aspirin (5.33% vs 5.83%; RRR 8.7%, 95% CI 0.3-16.5, p=0.043).
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