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 .
A new strategy for discontinuation of dual antiplatelet therapy: the RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation).
OBJECTIVES The goal of this study was to evaluate shorter duration ( 3 months ) dual antiplatelet therapy ( DAPT ) after  drug-eluting stent ( DES ) implantation .  BACKGROUND There have been few published reports of prospect i ve r and omized clinical studies comparing the safety and efficacy of shorter duration DAPT after DES implantation . METHODS We r and omly assigned 2,117 patients with coronary artery stenosis into 2 groups according to DAPT duration and stent type : 3-month DAPT following Endeavor zotarolimus-eluting stent ( E-ZES ) implantation ( E-ZES+3-month DAPT , n=1,059 ) versus 12-month DAPT following the other DES implantation ( st and ard therapy , n=1,058 ) . We hypothesized that the E-ZES+3-month DAPT would be noninferior to the st and ard therapy for the primary composite endpoint ( cardiovascular death , myocardial infa rct ion , stent thrombosis , target\vessel revascularization , or bleeding ) at 1 year . RESULTS The primary endpoint occurred in 40 ( 4.7 % ) patients assigned to E-ZES+3-month DAPT compared with 41 ( 4.7 % ) patients assigned to the st and ard therapy ( difference : 0.0 % ; 95 % confidence interval [ CI ] : -2.5 to 2.5 ; p=0.84 ; p<0.001 for noninferiority ) . The composite rates of any death , myocardial infa rct ion , or stent thrombosis were 0.8 % and 1.3 % , respectively ( difference : -0.5 % ; 95 % CI : -1.5 to 0.5 ; p=0.48 ) . The rates of stent thrombosis were 0.2 % and 0.3 % , respectively ( difference : -0.1 % ; 95 % CI : -0.5 to 0.3 ; p=0.65 ) without its further occurrence after cessation of clopidogrel in the E-ZES+3-month DAPT group . The rates of target vessel revascularization were 3.9 % and 3.7 % , respectively ( difference : 0.2 % ; 95 % CI : -2.3 to 2.6 ; p=0.70 ) . CONCLUSIONS E-ZES+3-month DAPT was noninferior to the st and ard therapy with respect to the occurrence of the primary endpoint . ( REal Safety and Efficacy of a 3-month dual antiplatelet Therapy following E-ZES implantation [ RESET ] ; NCT01145079 )
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 .