The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infa rct ion and ischaemic stroke , and an increased risk of major and minor bleeding compared with aspirin alone .
According to GRADE criteria , the quality of evidence was moderate for all outcomes except all-cause mortality ( low quality evidence ) and adverse events ( very low quality evidence )
BACKGROUND Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease .
Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease .
This is an up date to a previously published review from 2011 .
OBJECTIVES To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease , ischaemic cerebrovascular disease , peripheral arterial disease , or were at high risk of atherothrombotic disease , but did not have a coronary stent .
The curative effect comparison of two kinds of therapeutic regimens on decreasing the relative intensity of microembolic signal in CLAIR trial
BACKGROUND Microembolic signals ( MESs ) are direct markers of unstable large artery atherosclerotic plaques . In a previous study , we found that the number of MESs is associated with stroke recurrence and that clopidogrel plus aspirin more effectively reduce the number of MESs than does aspirin alone . Stroke recurrence is associated with not only the number of MESs but also the size of the MES , which can theoretically be estimated by monitoring the MES intensity via transcranial doppler ( TCD ) . Thus , we compared the effects of clopidogrel and aspirin with aspirin alone on MES intensity using TCD . METHODS We recruited 100 patients who experienced acute ischemic stroke or transient ischemic attack ( TIA ) within 7days of symptom onset . All patients also had large artery stenosis in the cerebral or carotid arteries and the presence of MES as revealed by TCD . The patients were r and omized to receive either aspirin or clopidogrel and aspirin for 7days . MES monitoring was performed on days 2 and 7 . RESULTS Intent-to-treat ( ITT ) analysis ( 46 patients in the dual therapy group , 52 patients in the monotherapy group ) and per- protocol ( PP ) analysis ( 25 patients in the dual therapy group , 31 patients in the monotherapy group ) were performed on 98 patients . The primary finding was that the MES intensity was dramatically reduced in the dual therapy group . ITT analysis of the dual therapy group revealed that the MES intensity was 8.04 ( 0 - 16 ) dB before treatment , 0.00 ( 0 - 17 ) dB on day 2 , and 0.00 ( 0 - 12 ) dB on day 7 ( P=0.000 ) . In the monotherapy group , the MES intensity was 9.00 ( 0 - 20 ) dB before treatment , 8.25 ( 0 - 17 ) dB on day 2 , and 7.0 ( 0 - 18 ) dB on day 7 ( P=0.577 ) . PP analysis revealed similar results . No severe hemorrhagic complications were detected . The two patients in this study who experienced stroke recurrence were in the monotherapy group . CONCLUSIONS Clopidogrel and aspirin more effectively decrease the MES intensity than aspirin alone in patients with large artery stenotic minor stroke or TIA
The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infa rct ion and ischaemic stroke , and an increased risk of major and minor bleeding compared with aspirin alone .
According to GRADE criteria , the quality of evidence was moderate for all outcomes except all-cause mortality ( low quality evidence ) and adverse events ( very low quality evidence )
BACKGROUND Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease .
Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease .
This is an up date to a previously published review from 2011 .
OBJECTIVES To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease , ischaemic cerebrovascular disease , peripheral arterial disease , or were at high risk of atherothrombotic disease , but did not have a coronary stent .