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 .
Clopidogrel improves microvascular endothelial function in subjects with stable coronary artery disease.
BACKGROUND Clopidogrel therapy has recently been shown to reduce cardiovascular events in patients with stable vascular disease . This benefit may be due to effects not exclusively related to platelet aggregation . The aim of this study was to evaluate the effect of clopidogrel therapy on microvascular endothelial function in subjects with stable coronary artery disease ( CAD ) . METHODS AND RESULTS Forty subjects with stable CAD were r and omised to clopidogrel therapy ( 75mg/day ) or control . Blood and endothelial function testing occurred at baseline , one week and three months following r and omisation . Microvascular endothelial function was assessed via reactive hyperaemic index ( RHI ) . Platelet function was assessed by adenosine diphosphate (ADP)-induced whole blood aggregation and the VerifyNow ™ system . Plasma markers of endothelial function ( asymmetric dimethylarginine , ADMA ) and oxidative stress ( myeloperoxidase , MPO ) were also tested . The primary endpoint was endothelial function assessment ( RHI ) at three months . At one week RHI increased by 20±10 % in the clopidogrel group ; this effect was maintained at three months ( 21±9 % increase from baseline ; P<0.01 ) . A significant decrease in ADP-induced platelet aggregation and P2Y12 reaction units was observed in the clopidogrel therapy group ( P<0.01 ) . There was no correlation between endothelial function and platelet function testing in the clopidogrel therapy group . CONCLUSION Clopidogrel therapy is associated with improved microvascular endothelial function in patients with stable CAD . This effect is independent of its effects on ADP-induced platelet reactivity
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 .