November 1, 2011Annals of Internal Medicine
Net Clinical Benefit of Adding Clopidogrel to Aspirin Therapy in Patients With Atrial Fibrillation for Whom Vitamin K Antagonists Are Unsuitable
Why the study?
Does adding clopidogrel to aspirin therapy improve net clinical benefit in patients with atrial fibrillation for whom vitamin K antagonists are unsuitable?
Population
10,041 patients with atrial fibrillation, 7,554 of whom were not candidates for warfarin therapy, from a…
Comparison
Clopidogrel added to aspirin therapy vs Control treatment (aspirin therapy alone)
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
Should not change practice in warfarin-unsuitable AF; hypothesis-generating and requires randomized confirmation.
Structured PICO
Does adding clopidogrel to aspirin therapy improve net clinical benefit in patients with atrial fibrillation for whom vitamin K antagonists are unsuitable?
P
Population
10,041 patients with atrial fibrillation (AF), 7,554 of whom were not candidates for warfarin therapy, from a global randomized clinical trial.
I
Intervention
Clopidogrel added to aspirin therapy
C
Comparator
Control treatment (aspirin therapy alone)
O
Outcome
Net clinical benefit (sum of weighted event incidence with dual antiplatelet therapy subtracted from control, expressed as ischemic stroke equivalents prevented per 100 patient-years)composite
Adding clopidogrel to aspirin in AF patients unsuitable for warfarin provides a modest net clinical benefit, though estimates cannot exclude the possibility of no benefit or small harm.
Limitations
- No attempt was made to relate deaths used for weighting to events
- disability data were missing for more than one half of patients
Cite This Study
Stuart J. Connolly (2011) studied this question.