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 .
Dual antiplatelet therapy versus aspirin alone in patients undergoing transcatheter aortic valve implantation.
Dual antiplatelet therapy ( DAPT ) with clopidogrel and aspirin is a widely accepted strategy in patients undergoing transcatheter aortic valve implantation ( TAVI ) , but this approach is not evidence based . The goal of the present study was to determine whether DAPT in patients undergoing TAVI is associated with improved outcomes compared to aspirin alone . From May 2009 to August 2010 , consecutive patients were r and omized to receive a 300-mg loading dose of clopidogrel on the day before TAVI followed by a 3-month maintenance daily dose of 75 mg plus aspirin 100 mg lifelong ( DAPT group ) or aspirin 100 mg alone ( ASA group ) . The primary end point was the composite of major adverse cardiac and cerebrovascular events , defined as death from any cause , myocardial infa rct ion , major stroke , urgent or emergency conversion to surgery , or life-threatening bleeding . The cumulative incidence of major adverse cardiac and cerebrovascular events at 30 days and 6 months was 14 % and 16 % , respectively . No significant differences between the DAPT and ASA groups were noted at both 30 days ( 13 % vs 15 % , p = 0.71 ) and 6 months ( 18 % vs 15 % ; p = 0.85 ) . In conclusion , the strategy of adding clopidogrel to aspirin for 3 months after TAVI was not found to be superior to aspirin alone . These results must be confirmed in a larger r and omized trial
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 .