Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone
Authors: Peter Eriksson
Journal: Annals of Internal Medicine (2005)

Letters20 September 2005Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin AlonePeter Eriksson, MD, PhDPeter Eriksson, MD, PhDFrom University Hospital, SE-901 85 Umea, Sweden.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-6-200509200-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although I read Schleinitz and Heidenreich's article (1) with interest, I am concerned about their conclusion. They stated, “In patients with high-risk acute coronary syndromes, 1 year of therapy with clopidogrel plus aspirin results in greater life expectancy than aspirin alone, at a cost within the traditional limits of cost-effectiveness.” There are evidently better ways to be cost-effective.In the CURE trial (2), patients with an acute coronary syndrome without ST-segment elevation received clopidogrel or placebo, in addition to aspirin, for a mean of 9 months. Nonetheless, most ischemic events (cardiovascular death, myocardial infarction, or stroke) occurred ...References1. Schleinitz MD, Heidenreich PA. A cost-effectiveness analysis of combination antiplatelet therapy for high-risk acute coronary syndromes: clopidogrel plus aspirin versus aspirin alone. Ann Intern Med. 2005;142:251-9. [PMID: 15710958] LinkGoogle Scholar2. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK, et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345:494-502. [PMID: 11519503] CrossrefMedlineGoogle Scholar3. Yusuf S, Mehta SR, Zhao F, Gersh BJ, Commerford PJ, Blumenthal M, et al. Early and late effects of clopidogrel in patients with acute coronary syndromes. Circulation. 2003;107:966-72. [PMID: 12600908] CrossrefMedlineGoogle Scholar4. Harding SA, Boon NA, Flapan AD. Antiplatelet treatment in unstable angina: aspirin, clopidogrel, glycoprotein IIb/IIIa antagonist, or all three? Heart. 2002;88:11-4. [PMID: 12067932] CrossrefMedlineGoogle Scholar5. Peters RJ, Mehta SR, Fox KA, Zhao F, Lewis BS, Kopecky SL, et al. Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study. Circulation. 2003;108:1682-7. [PMID: 14504182] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Peter Eriksson, MD, PhDAffiliations: From University Hospital, SE-901 85 Umea, Sweden.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Cost-Effectiveness Analysis of Combination Antiplatelet Therapy for High-Risk Acute Coronary Syndromes: Clopidogrel plus Aspirin versus Aspirin Alone Mark D. Schleinitz and Paul A. Heidenreich Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone Mark D. Schleinitz and Paul A. Heidenreich Cost-Effectiveness of Clopidogrel plus Aspirin versus Aspirin Alone Michael Rothberg Metrics Cited byMolecular mechanism of action for reversible P2Y12 antagonists 20 September 2005Volume 143, Issue 6Page: 464KeywordsAcute coronary syndromeAspirinConflicts of interestDrug therapyHemorrhageIschemic strokeLife expectancyMyocardial infarctionProspective studiesRelative risk ePublished: 20 September 2005 Issue Published: 20 September 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...