Why the study?
Does a higher dose of aspirin or clopidogrel reduce ischemic events in patients with acute coronary syndromes?
Does a higher dose of aspirin or clopidogrel reduce ischemic events in patients with acute coronary syndromes?
In ACS patients undergoing PCI, double-dose clopidogrel reduces stent thrombosis and ischemic events but increases bleeding, while higher dose aspirin offers no benefit.
Double-dose clopidogrel may warrant selective use in high-risk PCI despite bleeding; leaves open optimal antiplatelet dosing strategies in ACS.
Platelet inhibition is integral to the contemporary management of acute coronary syndromes. While aspirin and clopidogrel are used almost universally in patients treated with an early invasive strategy, the optimal dosing strategy for these drugs remains unknown. In a large randomized trial, the OASIS-CURRENT 7, investigators demonstrated no benefit of a higher dose of aspirin. There was no overall benefit of a higher dose of clopidogrel, although in patients treated with percutaneous coronary intervention a double-dose strategy was associated with a reduction in stent thrombosis and other ischemic events at the cost of an increased risk of bleeding events.
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Gurm et al. (2010) studied this question.
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