antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d)
DISEASE INTERVENTION COMPARISON RESULTS
Lancet. 1996 Nov 16;348(9038):1329-39 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, coronary disease, stroke, ischemic, peripheral arterial disease, or multiple risk factors The Use of
antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d)
As Treatment, Chronic
Is better Than
antiplatelet drugs, aspirin (325 mg/d)
To marginally reduce ischemic events (stroke, myocardial infarction or vascular death): 5.32% per year clopidogrel VS 5.83% per year aspirin, ARR 0.51% x year. Adverse effects was similar, i.e. intracraneal (0.33-0.47%) & GI bleeding (0.52-0.72%)
N Engl J Med. 2006 Apr 20;354(16):1706-17. Epub 2006 Mar 12 Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, coronary disease, stroke, ischemic, peripheral arterial disease, or multiple risk factors The Use of
combined antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d) added to low-dose aspirin
As Treatment, Chronic
Is equal Than
antiplatelet drugs, low-dose aspirin (75 to 160 mg/d) alone
To reduce, at 2 years, cardiovascular events (myocardial infarction, stroke, or cardiovascular death): 6.8% clopidogrel plus aspirin VS 7.3% aspirin alone. Bleeding was not significantly different. Combined treatment worse for non-symptomatic patients
Lancet. 2005 Nov 5;366(9497):1607-21 Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation The Use of
antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d) added to standard Tt (aspirin 100%, fibrinolysis 50%, anticoagulant 75%)
As Treatment, Acute
Is better Than
aspirin alone and standard antithrombotic Tt
To To reduce at 30 days vascular events (death, recurrent infarction, stroke): 9,2% with clopidogrel VS 10,1% aspirin alone.
N Engl J Med. 2012 Aug 30;367(9):817-25 Randomized Controlled Trial, Multicenter Study
IN stroke, ischemic, lacunar, recent The Use of
combined antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d) added to aspirin (325 mg/d)
As Treatment, Chronic
Is equal Than
aspirin alone
To modify the the risk of recurrent stroke: 2.5% per year dual therapy VS 2.7% per year aspirin alone
Stroke. 2012 Apr;43(4):1058-66. Epub 2012 Jan 26 Meta-Analysis
IN stroke, ischemic, thrombotic, transient ischemic attack The Use of
combined antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d) plus low-dose aspirin
As Prevention, Secondary
Is equal Than
aspirin alone
To reduce stroke recurrence (aspirin+clopidogrel VS aspirin alone : RR 0.67, 95%CI 0.37-1.23). However, a strong trend to reduce combined major cardiovascular events or death (OR 0.68, 95%CI 0.45-1.03, p=0.07).