November 5, 2002European Heart Journal
Clopidogrel does not suppress blood markers of coagulation activation in aspirin-treated patients with non-ST-elevation acute coronary syndromes
Why the study?
Does clopidogrel added to aspirin suppress blood markers of coagulation activation in patients with non-ST-elevation acute coronary syndromes?
Population
485 patients with non-ST-elevation acute coronary syndrome
Comparison
Clopidogrel plus aspirin for 3-12 months vs Placebo plus aspirin for 3-12 months
Design
RCT, randomized, placebo-controlled
Follow-up
30 days for biomarker assessment
Authors
Discussion
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Implication
Clopidogrel plus aspirin does not suppress coagulation markers in NSTE-ACS; indicates benefits occur via platelet inhibition independent of thrombin pathways.
Structured PICO
Does clopidogrel added to aspirin suppress blood markers of coagulation activation in patients with non-ST-elevation acute coronary syndromes?
P
Population
485 patients with non-ST-elevation acute coronary syndrome
I
Intervention
Clopidogrel (300 mg loading dose followed by 75 mg daily) plus aspirin (75-325 mg daily) for 3-12 months
C
Comparator
Placebo plus aspirin (75-325 mg daily) for 3-12 months
O
Outcome
Blood levels of P-selectin, prothrombin fragment F1.2, D-dimer, and von Willebrand factor at baseline, day 7 (or hospital discharge), and day 30surrogate
The addition of clopidogrel to aspirin in NSTE-ACS patients does not suppress markers of coagulation activation, suggesting its clinical benefits are mediated through other mechanisms and that thrombin generation persists.
Cite This Study
John W. Eikelboom (2002) studied this question.