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Cited by 2,837

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Atherothrombotic Events

Open access
Bhatt, Deepak L., Fox, Keith A.A., Hacke, Werner, Berger, Peter B., Black, Henry R., Boden, William E., Cacoub, Patrice, Cohen, Eric A., Creager, Mark A., Easton, J. Donald, Flather, Marcus D., Haffner, Steven M., Hamm, Christian W., Hankey, Graeme J., Johnston, S. Claiborne, Mak, Koon-Hou, Mas, Jean-Louis, Montalescot, Gilles, Pearson, Thomas A., Steg, P. Gabriel, Steinhubl, Steven R., Weber, Michael A., Brennan, Danielle M., Fabry-Ribaudo, Liz, Booth, Joan, Topol, Eric J.·2006·New England Journal of Medicine
DOI 10.1056/nejmoa060989
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Abstract

BACKGROUND: Dual antiplatelet therapy with clopidogrel plus low-dose aspirin has not been studied in a broad population of patients at high risk for atherothrombotic events. METHODS: We randomly assigned 15,603 patients with either clinically evident cardiovascular disease or multiple risk factors to receive clopidogrel (75 mg per day) plus low-dose aspirin (75 to 162 mg per day) or placebo plus low-dose aspirin and followed them for a median of 28 months. The primary efficacy end point was a composite of myocardial infarction, stroke, or death from cardiovascular causes. RESULTS: The rate of the primary efficacy end point was 6.8 percent with clopidogrel plus aspirin and 7.3 percent with placebo plus aspirin (relative risk, 0.93; 95 percent confidence interval, 0.83 to 1.05; P=0.22). The respective rate of the principal secondary efficacy end point, which included hospitalizations for ischemic events, was 16.7 percent and 17.9 percent (relative risk, 0.92; 95 percent confidence interval, 0.86 to 0.995; P=0.04), and the rate of severe bleeding was 1.7 percent and 1.3 percent (relative risk, 1.25; 95 percent confidence interval, 0.97 to 1.61 percent; P=0.09). The rate of the primary end point among patients with multiple risk factors was 6.6 percent with clopidogrel and 5.5 percent with placebo (relative risk, 1.2; 95 percent confidence interval, 0.91 to 1.59; P=0.20) and the rate of death from cardiovascular causes also was higher with clopidogrel (3.9 percent vs. 2.2 percent, P=0.01). In the subgroup with clinically evident atherothrombosis, the rate was 6.9 percent with clopidogrel and 7.9 percent with placebo (relative risk, 0.88; 95 percent confidence interval, 0.77 to 0.998; P=0.046). CONCLUSIONS: In this trial, there was a suggestion of benefit with clopidogrel treatment in patients with symptomatic atherothrombosis and a suggestion of harm in patients with multiple risk factors. Overall, clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes. (ClinicalTrials.gov number, NCT00050817.).

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Metadata

Authors
Bhatt, D. L., Fox, K. A. A., Hacke, W., Berger, P. B., Black, H. R., Boden, W. E., Cacoub, P., Cohen, E. A., Creager, M. A., Easton, J. D., Flather, M. D., Haffner, S. M., Hamm, C. W., Hankey, G. J., Johnston, S. C., Mak, K.-H., Mas, J.-L., Montalescot, G., Pearson, T. A., Steg, P. G., Steinhubl, S. R., Weber, M. A., Brennan, D. M., Fabry-Ribaudo, L., Booth, J., & Topol, E. J.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2006-04-20
Volume
354
Issue
16
Pages
1706-1717
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa060989
OpenAlex
W2100209149
Cited by
2,837
References
2
FWCI
167.97
Type
journal article
Language
en
Open access
bronze

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