Key result
Preoperative clopidogrel plus aspirin significantly reduced the risk of >20 cerebral emboli within 3 hours of carotid endarterectomy compared to placebo (OR 10.23; 95% CI 1.3-83.3; P=0.01).
Why the study?
Does preoperative clopidogrel reduce postoperative cerebral emboli in patients undergoing carotid endarterectomy on routine aspirin therapy?
Population
100 patients undergoing carotid endarterectomy (CEA) on routine aspirin therapy (150 mg)
Comparison
Clopidogrel 75 mg administered the night before… vs Placebo administered the night before surgery
Design
RCT, Randomized to clopidogrel or placebo, Placebo-controlled
Follow-up
3 hours postoperatively
Authors
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Supports preoperative clopidogrel addition to aspirin for carotid endarterectomy; extends randomized evidence on cerebral embolic risk reduction.
RCT (n=100)
randomized
Does preoperative clopidogrel reduce postoperative cerebral emboli in patients undergoing carotid endarterectomy on routine aspirin therapy?
Odds Ratio: 10.23 (95% CI 1.3–83.3)
p-value: p=0.01
Preoperative administration of clopidogrel in addition to aspirin significantly reduces postoperative cerebral embolization in patients undergoing carotid endarterectomy without increasing bleeding complications.
Payne et al. (2004) conducted an RCT in Carotid endarterectomy (n=100). Clopidogrel vs. Placebo was evaluated on Having >20 cerebral emboli detected by transcranial Doppler within 3 hours of CEA (OR 10.23, 95% CI 1.3-83.3, p=0.01). Preoperative clopidogrel plus aspirin significantly reduced the risk of >20 cerebral emboli within 3 hours of carotid endarterectomy compared to placebo (OR 10.23; 95% CI 1.3-83.3; P=0.01).
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