Why the study?
Does clopidogrel reduce the combined end point of cardiovascular death, nonfatal myocardial infarction, or stroke in patients presenting with acute coronary syndromes without ST-segment elevation?
Does clopidogrel reduce the combined end point of cardiovascular death, nonfatal myocardial infarction, or stroke in patients presenting with acute coronary syndromes without ST-segment elevation?
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Clopidogrel reduces major adverse cardiovascular events in patients with NSTE-ACS managed conservatively, though at the cost of increased bleeding.
In a large, randomized, placebo-controlled trial in centers that use a conservative approach to acute coronary syndromes, the antiplatelet drug clopidogrel (Plavix) decreased the rate of the combined end point of cardiovascular death, nonfatal myocardial infarction, or stroke by 20% in patients presenting with acute coronary syndromes without ST-segment elevation. The benefit was at the cost of an increase in bleeding, however. This strategy may need to be tailored in centers that use a more aggressive treatment strategy of early angiography and revascularization.
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Gerschutz et al. (2002) studied this question.
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