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 Effect of Combined Clopidogrel and Aspirin Therapy after Off-Pump Coronary Surgery
Objective The purpose of this r and omized study was to evaluate the effect on graft patency by adding clopidogrel to aspirin in off-pump coronary artery bypass ( OPCAB ) grafting and the possible side effects of such therapy . Methods Twenty patients who underwent st and ard OPCAB through median sternotomy were r and omized immediately after surgery in two groups . Patients in group A ( n = 10 ) received 100 mg of aspirin starting preoperatively , continuing indefinitely . Patients in group B received 100 mg of aspirin and , in addition , 75 mg of clopidogrel starting immediately after the operation and for 3 months . Postoperative bleeding and other perioperative parameters were compared . Angiography was repeated 3 months after surgery to determine the patency and quality of grafts . Results Preoperative risk factors were similar in the two groups . There was no significant difference in average number of distal anastomosis ( P = 0.572 ) , operation time ( P = 0.686 ) , postoperative bleeding ( P = 0.256 ) , ventilation time ( P = 0.635 ) , and intensive care unit stay ( P = 0.065 ) . Length of stay was shorter in group B ( P = 0.024 ) . There was no postoperative complication in either groups . Eight of 27 grafts in group A and 2 of 29 grafts in group B ( P = 0.037 ) were occluded at the time of control angiography . Conclusions Early administration of a combined regimen of clopidogrel and aspirin after OPCAB grafting is not associated with increased postoperative bleeding or other major complications . Despite the small number of patients in this study and small number of examined grafts , the results suggest that the addition of clopidogrel may increase graft patency after OPCAB grafting
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 .