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 .
Impact of clopidogrel and aspirin treatment on the expression of proteins in platelets from type-2 diabetic patients with stable coronary ischemia.
The purpose of this study was to compare the effect of dual antiplatelet therapy [ clopidogrel + aspirin ( ASA ) ] with respect to ASA on the protein expression of platelets from controlled type-2 diabetic patients with stable coronary ischemia . Patients had been taking ASA ( 100 mg day ) and they were r and omized to receive ( n = 29 ) or not ( n = 28 ) 75 mg day clopidogrel for 12 ± 2 weeks in a blind form . Protein expression was analyzed by two-dimensional electrophoresis and mass spectrometry . The protein expression of a limited number of proteins such as actin-binding protein isotypes 2 and 5 , lactate dehydrogenase , serotransferrin isotype 4 , protein disulfide isomerase-A3 isotype 1 , fibrinogen beta chain isotype 5 , Ras-related protein Rab-7b isotypes 1 and 6 , and immunoglobulin heavy chain was changed after dual antiplatelet therapy . Plasma level of platelet factor 4 ( PF4 ) , an in vivo marker of platelet activity , was not different between both groups . These changes suggest lower platelet reactivity after dual antiplatelet therapy in the studied patients . However , the variation in platelet proteome was lower than it would be initially expected , taking into account the apparent clinical beneficial effects of dual antiplatelet therapy . PF4 plasma level was not further decreased in the platelets treated for a longer time than 9 - 12 months with ASA + clopidogrel , as compared with ASA alone
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 .