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 .
Effects of clopidogrel on soluble CD40 ligand and on high-sensitivity C-reactive protein in patients with stable coronary artery disease.
BACKGROUND Antiplatelet therapy with clopidogrel decreases ischemic complication especially in patients with acute coronary syndromes or after percutaneous coronary interventions . Our study was design ed to test the effects of clopidogrel on soluble CD40 lig and ( sCD40l ) and on high-sensitivity C-reactive protein ( hs-CRP ) in patients with stable coronary artery disease ( CAD ) . METHODS This is a r and omized , double-blind , placebo-controlled study . A total of 73 patients with stable CAD for > 6 months were r and omized to receive either clopidogrel ( loading dose 300 mg followed by 75 mg/d ) for 8 weeks or placebo . Soluble CD40 lig and and hs-CRP were measured at baseline and at completion of the study . RESULTS All patients were on aspirin therapy , and 74 % were on statins .  Median and interquartile ranges ( IQR ) of sCD40l decreased from 64 pg/mL ( 43 - 99 ) at baseline to 53 pg/mL ( 35 - 77 ) at 8 weeks ( P = .03 ) in the clopidogrel group and remained unchanged in the placebo group ( 59 pg/mL , IQR 35 - 77 vs 55 pg/mL , IQR 35 - 78 ) ( P = non significant ) . Levels of hs-CRP were not affected by therapy and remained unchanged in both groups . CONCLUSIONS In patients with stable CAD , clopidogrel inhibits the release of sCD40l by platelets , which may contribute to the clinical benefit provided by this drug . This , however , does not translate in a reduction of sub clinical inflammation , as measured by hs-CRP
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 .