Key result
Clopidogrel plus aspirin reduces MI and ischemic stroke vs aspirin alone but increases major bleeding.
Why the study?
The benefit and risk of adding clopidogrel to aspirin for preventing cardiovascular events in patients at high risk or with established cardiovascular disease without coronary stents was uncertain.
Does the addition of clopidogrel to aspirin reduce mortality and cardiovascular events in patients at high risk for or with established cardiovascular disease compared with aspirin alone?
Does the addition of clopidogrel to aspirin reduce mortality and cardiovascular events in patients at high risk for or with established cardiovascular disease compared with aspirin alone?
Answers are grounded in this paper and cite their sources.
In patients at high risk for or with established cardiovascular disease without a coronary stent, adding clopidogrel to aspirin reduces myocardial infarction and ischemic stroke but increases major bleeding without a mortality benefit.
Clinical Question: Among patients at high risk for or with established cardiovascular disease (ie, history of peripheral artery disease, stroke, or coronary artery disease without a coronary stent), is the addition of clopidogrel to aspirin associated with lower risk of mortality and cardiovascular events compared with aspirin alone? Bottom Line: Clopidogrel plus aspirin is associated with a reduced risk for myocardial infarction and ischemic stroke and an increased risk for major bleeding compared with aspirin alone among patients at high risk for or with an established cardiovascular disease but without a coronary stent. However, combined therapy is not associated with lower mortality.
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Donadini et al. (2018) conducted a review in High risk for or with established cardiovascular disease. Clopidogrel plus aspirin vs. Aspirin alone was evaluated on Mortality and cardiovascular events. Clopidogrel plus aspirin reduced the risk of myocardial infarction and ischemic stroke but increased major bleeding compared with aspirin alone, with no difference in mortality.
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