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 .
The effectiveness and safety of dual antiplatelet therapy in ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis in Chinese patients
Background : There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis . The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis . Methods : Patients with clinical ly evident acute cerebral infa rct ion or transient ischemic attack combined with intracranial and extracranial arteriostenosis ( greater than 50 % ) who were unsuitable or reluctance to perform stent implantation were enrolled in this study . We r and omly assigned these patients to receive clopidogrel ( 75 or 50 mg ) plus aspirin ( 100 mg ) or aspirin ( 100 mg ) once daily through 90 days , and followed them for 90 days . We examined the main endpoints including the recurrence of stroke , death from cardiovascular causes , and bleeding events . Results : In all , 200 patients were recruited and followed for 90 days . Ischemic stroke occurred in 6 patients ( 9.1 % ) treated with 50 mg clopidogrel and aspirin , 6 patients ( 9.1 % ) receiving 75 mg clopidogrel and aspirin , whereas 19 patients ( 27.9 % ) in the aspirin group ( aspirin alone vs copidogrel 50 mg plus aspirin ; 95 % confidence intervals 1.704–23.779 , P < 0.05 ; aspirin alone vs copidogrel 75 mg plus aspirin ; 95 % confidence intervals 1.190–13.240 , P < 0.05 ) . There were more hemorrhagic events among recipients ( 3 patients [ 2.3 % ] ) in the copidogrel plus aspirin group than aspirin recipients ( 0 patient [ 0 % ] ) , including 1 subcutaneous hemorrhage in the group of 50 mg clopidogrel and aspirin , doubling the number of nasal and gum bleeding in the group of 75 mg clopidogrel and aspirin ( P > 0.05 ) . No intracranial hemorrhage and gastro-intestinal hemorrhage occurred in these 3 groups . Conclusion : Accordingly , 50 mg clopidogrel plus aspirin , and 75 mg clopidogrel plus aspirin were all superior to aspirin alone as stroke prevention in patients with cerebral infa rct ion or transient ischemic attack combined with intracranial and extracranial arteriostenosis . The effect of secondary stroke prevention was similar between 50 mg clopidogrel plus aspirin and 75 mg clopidogrel plus aspirin . The therapy of 75 mg clopidogrel plus aspirin result ed in a worrisome tread in bleeding events
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 .