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 .
Aspirin plus clopidogrel therapy increases early venous graft patency after coronary artery bypass surgery a single-center, randomized, controlled trial.
OBJECTIVES We sought to evaluate the effect of aspirin plus clopidogrel versus aspirin alone on saphenous vein graft occlusion at 3 months after coronary artery bypass grafting ( CABG ) . BACKGROUND Prevalence of graft occlusion is high after CABG . Aggressive antiplatelet therapy is expected to improve early post-operative graft patency . METHODS From December 2007 through December 2008 , 249 consecutive patients undergoing elective CABG at Fuwai Hospital were r and omly assigned to 2 groups : 124 received aspirin ( 100 mg ) plus clopidogrel ( 75 mg ) daily ( AC group ) , and 125 received aspirin ( 100 mg ) alone daily ( A group ) . Antiplatelet therapies were initiated when post-operative chest tube drainage was ≤ 30 cc/h for 2 h. All participants were invited for clinical follow-up and 64-slice multislice computed tomography angiography ( MSCTA ) analysis at 3 months post-operatively . Generalized estimating equations analysis was used to determine predictors of graft patency . RESULTS One participant , from group A , died before 3-month follow-up . Of the remaining 248 patients , 224 ( 90.3 % ) underwent MSCTA . Participants had similar pre-operative and intraoperative characteristics at baseline . No significant differences were observed in intraoperative transit-time flow measurement findings or major adverse cardiac-related events . Three-month MSCTA follow-up revealed that saphenous vein graft patency was 91.6 % ( 219 of 239 ) in the AC group versus 85.7 % ( 198 of 231 ) in the A group ( p = 0.043 ) . In multivariate analysis , combined antiplatelet therapy independently increased venous graft patency ( p = 0.045 ) . CONCLUSIONS Aspirin plus clopidogrel is more effective in venous graft patency than aspirin alone in the short term after CABG , but further , long-term study is needed . ( The Clopidogrel and Aspirin After Surgery for Coronary Artery Disease ; NCT00776477 )
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 .