Clopidogrel plus aspirin vs aspirin alone for preventing cardiovascular disease in high risk persons not presenting acutely
Sübutlu məlumatların xülasələri
03.09.2013 • Sonuncu dəyişiklik 03.09.2013
Editors
The long-term use of clopidogrel plus aspirin appears not to be more effective than aspirin alone in patients at high risk of cardiovascular disease or with established cardiovascular disease but not presenting acutely.
The CHARISMA trial (n = 15 603) was included in a Cochrane review . In persons with pre-existing cardiovascular diseases or risk factors but not presenting acutely, clopidogrel 75 mg daily in combination with aspirin non-significantly reduced cardiovascular events (OR 0.92, 95% CI 0.81 to 1.04) and non-significantly increased major bleeding (OR 1.25, 95% CI 0.97 to 1.63) during a median follow-up of 28 months. Clopidogrel did not decrease death from cardiovascular (OR 1.04, 95% CI 0.87 to1.25) or any causes (OR 0.99, 95% CI 0.86 to1.14). For every 1000 people treated for
an average of 28 months, 5 cardiovascular events would be avoided and 3 major bleeds would be caused.
Comment: The quality of evidence is downgraded by heterogeneity. It is possible that some subgroups of patients might benefit (as do those with acute coronary syndrome; see ).
Ədəbiyyat
- Squizzato A, Keller T, Romualdi E, Middeldorp S. Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular disease. Cochrane Database Syst Rev 2011;(1):CD005158. .
- Bhatt DL, Fox KA, Hacke W, Berger PB, Black HR, Boden WE, Cacoub P, Cohen EA, Creager MA, Easton JD, Flather MD, Haffner SM, Hamm CW, Hankey GJ, Johnston SC, Mak KH, Mas JL, Montalescot G, Pearson TA, Steg PG, Steinhubl SR, Weber MA, Brennan DM, Fabry-Ribaudo L, Booth J, Topol EJ, CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006 Apr 20;354(16):1706-17.