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 comparison of 1-month and 6-month clopidogrel therapy on clinical and angiographic outcome after stent implantation
In this study , we aim ed to disclose the net effect of long-term ( 6-month ) clopidogrel treatment as compared to that of short-term ( 1-month ) treatment in the poststenting period . A total of 278 patients with successful stent implantation were involved in the study . After preloading with 300 mg of clopidogrel orally ( p.o . ) 24 h prior to the procedure , r and omly selected patients were given either 75 mg p.o . for 1 month ( group A ) or 75 mg p.o . for 6 months ( group B ) . The patients were followed up clinical ly and underwent control angiography at 6 months regardless of their clinical status to delineate the coronary anatomy and assess quantitative computer-assisted ( QCA ) analysis . In 140 ( 50.4 % ) patients ( group A ) , 244 ( 50.6 % ) stents were used to treat 237 coronary lesions , and in 138 patients ( group B ) , 238 ( 49.4 % ) stents were used to treat 238 coronary lesions . There was no difference between the groups with respect to any of the clinical characteristics , intracoronary thrombus , antiaggregant therapy , the type of lesion , vessel score index , and baseline QCA parameters . In 62 patients binary in-stent restenosis ( ISR ) was determined with no statistical difference between the groups ( group A : 20.7 % vs group B : 23.9 % , P = not significance ) . There was also no difference between the two groups at 6 months regarding QCA parameters . Thirty-seven of the 62 patients with restenosis have developed major adverse coronary events such as death , myocardial infa rct ion , and target vessel revascularization ( group A : 12.9 % vs group B : 13.8 % , P = not significant ) . In patients with chronic coronary syndrome , in the poststenting period , 6-month clopidogrel use as an adjunct to aspirin has shown no benefit over 1 month use with respect to clinical outcome and angiographic outcome , such as restenosis rate , follow-up , minimal luminal diameter , late loss , lost index , and net gain
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 .