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 influence of body mass index on outcomes and the benefit of antiplatelet therapy following percutaneous coronary intervention.
UNLABELLED In general , obesity is associated with better outcome in patients undergoing percutaneous coronary interventions ( PCI ) . One small study has suggested that these patients do not achieve adequate platelet inhibition with clopidogrel and that this may shape clinical outcomes . We evaluated the relationship between body mass index ( BMI ) and clinical outcomes at 1 year following PCI in patients r and omized to clopidogrel or placebo in the CREDO trial . METHODS AND RESULTS BMI , baseline clinical characteristics and clopidogrel regimen were assessed in 2,116 patients . The primary study endpoint was the 1-year composite of death , MI or stroke . A total of 342 patients had low or normal BMI ( < 25 kg per m2 ) , 847 were overweight ( 25 - 29.9 kg per m2 ) , 810 were obese ( 30 - 39.9 kg per m2 ) and 113 were very obese ( greater than or equal to 40 kg per m2 ) . Obese patients were more likely to be young males with diabetes , hypertension and hyperlipidemia ( p < 0.01 ) . Bleeding complications occurred in 38 % of low BMI , 32 % of overweight/obese , and 25 % of very obese patients ( p = 0.03 ) . R and omization to clopidogrel was associated with a 25 % risk reduction in 1-year death , MI or stroke events , as BMI increased by every 5 kg per m2 ( p = 0.009 ) . CONCLUSION In general , increasing BMI was associated with better efficacy and bleeding outcomes at 1 year in this nonurgent PCI population . R and omization to early- and long-term clopidogrel was associated with even further improvements in those with increasing BMI
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 .