January 1, 2008Cerebrovascular Diseases
Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Stroke in Patients with a History of Atrial Fibrillation: Subgroup Analysis of the CHARISMA Randomized Trial
Why the study?
Does clopidogrel plus aspirin reduce the risk of stroke compared to aspirin alone in patients with a history of atrial fibrillation?
Population
593 participants with a history of atrial fibrillation and stable cardiovascular disease or multiple…
Comparison
Clopidogrel 75 mg per day plus aspirin vs Aspirin alone (75-162 mg per day)
Design
RCT
Follow-up
median 2.3 years
Authors
Discussion
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Implication
No stroke reduction with clopidogrel plus aspirin versus aspirin alone in AF; reinforces anticoagulation as preferred over dual antiplatelet therapy.
Structured PICO
Does clopidogrel plus aspirin reduce the risk of stroke compared to aspirin alone in patients with a history of atrial fibrillation?
P
Population
593 participants with a history of atrial fibrillation and stable cardiovascular disease or multiple cardiovascular risk factors, mean age 70 years, 78% men.
I
Intervention
Clopidogrel 75 mg per day plus aspirin (75-162 mg per day)
C
Comparator
Aspirin alone (75-162 mg per day)
O
Outcome
Stroke (ischemic and hemorrhagic)hard clinical
The addition of clopidogrel to aspirin does not reduce the risk of stroke but may increase severe bleeding in patients with a history of atrial fibrillation.
Limitations
- Post-hoc subgroup analysis
Cite This Study
Hart et al. (2008) studied this question.