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 .
Incidence of dyspnea and assessment of cardiac and pulmonary function in patients with stable coronary artery disease receiving ticagrelor, clopidogrel, or placebo in the ONSET/OFFSET study.
OBJECTIVES We prospect ively assessed cardiac and pulmonary function in patients with stable coronary artery disease ( CAD ) treated with ticagrelor , clopidogrel , or placebo  in the ONSET/OFFSET ( A Multi-Centre R and omised , Double-Blind , Double-Dummy Parallel Group Study of the Onset and Offset of Antiplatelet Effects of AZD6140 Compared With Clopidogrel and Placebo With Aspirin as Background Therapy in Patients With Stable Coronary Artery Disease ) study . BACKGROUND Ticagrelor reduces cardiovascular events more effectively than clopidogrel in patients with acute coronary syndromes . Dyspnea develops in some patients treated with ticagrelor , and it is not known whether this is associated with changes in cardiac or pulmonary function . METHODS In all , 123 stable aspirin-treated CAD patients r and omly received either ticagrelor ( 180 mg load , then 90 mg twice daily ; n=57 ) , clopidogrel ( 600 mg load , then 75 mg daily ; n=54 ) , or placebo ( n=12 ) for 6 weeks in a double-blind , double-dummy design . Electrocardiography , echocardiography , serum N-terminal pro-brain natriuretic peptide , and pulmonary function tests were performed before ( baseline ) and 6 weeks after drug administration and /or after development of dyspnea . RESULTS After drug administration , dyspnea was reported by 38.6 % , 9.3 % , and 8.3 % of patients in the ticagrelor , clopidogrel , and placebo groups , respectively ( p<0.001 ) . Most instances were mild and /or lasted<24 h , although 3 patients discontinued ticagrelor because of dyspnea . Eight of 22 and 17 of 22 ticagrelor-treated patients experiencing dyspnea did so within 24 h and 1 week , respectively , after drug administration . In all treatment groups , and in ticagrelor-treated patients with dyspnea , there were no significant changes between baseline and 6 weeks in any of the cardiac or pulmonary function parameters . CONCLUSIONS Dyspnea is commonly associated with ticagrelor therapy , but was not associated in this study with any adverse change in cardiac or pulmonary function . ( A Multi-Centre R and omised , Double-Blind , Double-Dummy Parallel Group Study of the Onset and Offset of Antiplatelet Effects of AZD6140 Compared With Clopidogrel and Placebo With Aspirin as Background Therapy in Patients With Stable Coronary Artery Disease [ ONSET/OFFSET ] ; NCT00528411 )
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 .