Cited by 2,102Atrial Fibrillation Management and OutcomesAntiplatelet Therapy and Cardiovascular DiseasesAcute Ischemic Stroke Management

The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.

Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation

Open access

The ACTIVE Investigators·2009·New England Journal of Medicine

DOI 10.1056/nejmoa0901301

Open this paper in CoChat — free account Open PDF

Abstract

BACKGROUND: Vitamin K antagonists reduce the risk of stroke in patients with atrial fibrillation but are considered unsuitable in many patients, who usually receive aspirin instead. We investigated the hypothesis that the addition of clopidogrel to aspirin would reduce the risk of vascular events in patients with atrial fibrillation. METHODS: A total of 7554 patients with atrial fibrillation who had an increased risk of stroke and for whom vitamin K-antagonist therapy was unsuitable were randomly assigned to receive clopidogrel (75 mg) or placebo, once daily, in addition to aspirin. The primary outcome was the composite of stroke, myocardial infarction, non-central nervous system systemic embolism, or death from vascular causes. RESULTS: At a median of 3.6 years of follow-up, major vascular events had occurred in 832 patients receiving clopidogrel (6.8% per year) and in 924 patients receiving placebo (7.6% per year) (relative risk with clopidogrel, 0.89; 95% confidence interval [CI], 0.81 to 0.98; P=0.01). The difference was primarily due to a reduction in the rate of stroke with clopidogrel. Stroke occurred in 296 patients receiving clopidogrel (2.4% per year) and 408 patients receiving placebo (3.3% per year) (relative risk, 0.72; 95% CI, 0.62 to 0.83; P<0.001). Myocardial infarction occurred in 90 patients receiving clopidogrel (0.7% per year) and in 115 receiving placebo (0.9% per year) (relative risk, 0.78; 95% CI, 0.59 to 1.03; P=0.08). Major bleeding occurred in 251 patients receiving clopidogrel (2.0% per year) and in 162 patients receiving placebo (1.3% per year) (relative risk, 1.57; 95% CI, 1.29 to 1.92; P<0.001). CONCLUSIONS: In patients with atrial fibrillation for whom vitamin K-antagonist therapy was unsuitable, the addition of clopidogrel to aspirin reduced the risk of major vascular events, especially stroke, and increased the risk of major hemorrhage. (ClinicalTrials.gov number, NCT00249873.)

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1056/nejmoa0901301

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Atrial fibrillation as an independent risk factor for stroke: the Framingham study
Wolf, P. A., Abbott, R. D., & Kannel, W. B. (1991) · Stroke · doi:10.1161/01.str.22.8.983 · Cited by 7,388
Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation
(2001) · New England Journal of Medicine · doi:10.1056/nejmoa010746 · Cited by 6,470
Self-citation
Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation
Hart, R. G., Pearce, L. A., & Aguilar, M. I. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-12-200706190-00007 · Cited by 4,793
Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial
(2006) · The Lancet · doi:10.1016/s0140-6736(06)68845-4 · Cited by 1,952
Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial
(2005) · The Lancet · doi:10.1016/s0140-6736(05)67660-x · Cited by 1,858
ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation—Executive Summary
Fuster, V., Rydén, L., Cannom, D. S., Crijns, H. J. G. M., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Heuzey, J. L., Kay, G. N., Lowe, J. E., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.009 · Cited by 1,161
Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited
Watson, T., Shantsila, E., & Lip, G. Y. H. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60040-4 · Cited by 1,124
Antithrombotic Therapy in Atrial Fibrillation
Singer, D. E., Albers, G. W., Dalen, J. E., Fang, M. C., Go, A. S., Halperin, J. L., Lip, G. Y. H., & Manning, W. J. (2008) · CHEST Journal · doi:10.1378/chest.08-0678 · Cited by 758
Oral Anticoagulants vs Aspirin in Nonvalvular Atrial Fibrillation
van Walraven, C., Hart, R. G., Singer, D. E., Laupacis, A., Connolly, S. J., Petersen, P., Koudstaal, P. J., Chang, Y., & Hellemons, B. S. P. (2002) · JAMA · doi:10.1001/jama.288.19.2441 · Cited by 715
American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes31This document was approved by the American College of Cardiology Board of Trustees in November 2001.32When citing this document, the American College of Cardiology would appreciate the following citation format: Cannon CP, Battler A, Brindis RG, Cox JL, Ellis SG, Every NR, Flaherty JT, Harrington RA, Krumholz HM, Simoons ML, Van de Werf FJJ, Weintraub WS. ACC Key Elements and Data Definitions for Measuring the Clinical Management and Outcomes of Patients with Acute Coronrary Syndromes: a report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee). J Am Coll Cardiol 2001;38:2114–30.33This document is available on the World Wide Web site of the American College of Cardiology (www.acc.org). Reprints of this document may be purchased for $5.00 each by calling 1-800-253-4636 or by writing to the American College of Cardiology, Educational Services, 9111 Old Georgetown Road, Bethesda, Maryland 20814-1699. © 2001 by the American College of Cardiology
Cannon, C. P., Battler, A., Brindis, R. G., Cox, J. L., Ellis, S. G., Every, N. R., Flaherty, J. T., Harrington, R. A., Krumholz, H. M., Simoons, M. L., et al. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01702-8 · Cited by 673

Flagged first, then by citations

Show all 25 references

Sorted by citations

Items 901–1,000 of 1,000

Personalized approach to primary and secondary prevention of ischemic stroke
Polívka, J., Rohan, V., Ševčík, P., & Polívka, J. (2014) · The EPMA Journal · doi:10.1186/1878-5085-5-9 · Cited by 14
A review of the two major regulatory pathways for non-proprietary low-molecular-weight heparins
Ofosu, F. A. (2012) · Thrombosis and Haemostasis · doi:10.1160/th11-06-0409 · Cited by 14
Use of Direct-Acting Oral Anticoagulants in Nonagenarians: A Call for More Data
Stöllberger, C., Brooks, R., Finsterer, J., & Pachofszky, T. (2016) · Drugs & Aging · doi:10.1007/s40266-016-0363-4 · Cited by 14
Stroke Prevention in Atrial Fibrillation and Valvular Heart Disease
Ahmad, S., & Wilt, H. (2016) · The Open Cardiovascular Medicine Journal · doi:10.2174/1874192401610010110 · Cited by 14
Time to Revisit the Time in the Therapeutic Range
Reiffel, J. A. (2017) · Journal of Atrial Fibrillation · doi:10.4022/jafib.1569 · Cited by 14
The contribution of real-world evidence to cost-effectiveness analysis: case study of Dabigatran etexilate in France
de Pouvourville, G., Blin, P., & Karam, P. (2019) · The European Journal of Health Economics · doi:10.1007/s10198-019-01123-5 · Cited by 14
Manejo de los pacientes con fibrilación auricular en los servicios de urgencias hospitalarios (actualización 2012)
Martı́n, A., Lozano, I. F., Puig, B. C.-V., Tercedor, L., del Arco, C., Ynsaurriaga, F. A., Méndez, C. S., & Girbau, L. M. (2012) · Emergencias · Cited by 14
Clopidogrel and PPI Interaction: Clinically Relevant or Not?
Harrison, R. W., & Mahaffey, K. W. (2011) · Current Cardiology Reports · doi:10.1007/s11886-011-0233-y · Cited by 14
Update of Cerebral Vascular Disease: Issues for the Primary Care Physician
Gorelick, P. B., & Ruland, S. D. (2010) · Disease-a-Month · doi:10.1016/j.disamonth.2009.12.001 · Cited by 14
Current Status of Antiplatelet Agents to Prevent Stroke
Field, T. S., & Benavente, O. (2010) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-010-0162-y · Cited by 14
Guidelines for the Primary Prevention of Stroke A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association The American Academy of Neurology affirms the value of these guidelines as an educational tool for neurologists. Endorsed by the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, and the Preventive Cardiovascular Nurses Association
Meschia, J. F., Bushnell, C., Boden-Albala, B. M., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Fornage, M., Goldstein, L. B., et al. (2014) · Cited by 15
Intracranial Hemorrhage Risk in the Era of Antithrombotic Therapies for Ischemic Stroke
Thon, J. M., & Gurol, M. E. (2016) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-016-0453-y · Cited by 14
Impact of Vitamin K Antagonists on Quality of Life in a Prospective Cohort of 807 Atrial Fibrillation Patients
Kooistra, H., Piersma-Wichers, M. G., Kluin‐Nelemans, H. C., Veeger, N. J. G. M., & Meijer, K. (2016) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.115.002612 · Cited by 14
“This could possibly help to persuade the large group of AF patients who are at risk for stroke but are afraid to start VKA treatment.(21,22) The very high convenience scores imply that for the general group of AF patients, no relevant improvement in convenience can be expected from switching to alternative treatments…”
Background
Novel oral anticoagulants to prevent stroke in atrial fibrillation
Verheugt, F. W. A. (2010) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2009.235 · Cited by 14
Systemic Embolic Events (SEE) in Atrial Fibrillation
Chatterjee, N. A., & Lubitz, S. A. (2015) · Circulation · doi:10.1161/circulationaha.115.018172 · Cited by 14
Gone Fishing (for Silent Atrial Fibrillation)
Ahmad, Y., & Kirchhof, P. F. (2013) · Circulation · doi:10.1161/circulationaha.112.000985 · Cited by 14
Atrial fibrillation, moderate chronic kidney disease, and stroke prevention: new anticoagulants, new hope
Hohnloser, S. H., & Connolly, S. J. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr344 · Cited by 14
Cost–Effectiveness of Clopidogrel Plus Aspirin for Stroke Prevention in Patients With Atrial Fibrillation in Whom Warfarin Is Unsuitable
Coleman, C. I., Straznitskas, A. D., Sobieraj, D. M., Kluger, J., & Anglade, M. W. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.11.034 · Cited by 13
Coronary Stent Implantation in Patients Committed to Long-term Oral Anticoagulation Therapy
Rubboli, A., Kovacic, J. C., Mehran, R., & Lip, G. Y. H. (2011) · CHEST Journal · doi:10.1378/chest.10-2719 · Cited by 13
Antiplatelet Therapy in Cerebrovascular Disorders
Weber, R., Brenck, J., & Diener, H. (2012) · Handbook of experimental pharmacology · doi:10.1007/978-3-642-29423-5_21 · Cited by 14
Melagatran, a direct thrombin inhibitor, but not edoxaban, a direct factor Xa inhibitor, nor heparin aggravates tissue factor-induced hypercoagulation in rats
Furugohri, T., Fukuda, T., Tsuji, N., Kita, A., MORISHIMA, Y., & Shibano, T. (2012) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2012.04.031 · Cited by 13
Ineligibility for Anticoagulation in Patients with Atrial Fibrillation
Conde, I. D., & Halperin, J. L. (2013) · The American Journal of Medicine · doi:10.1016/j.amjmed.2012.07.001 · Cited by 12
“006).(35) These rates of leeding may be comparable with that associated with anicoagulation therapy, especially to the newer agents.”
Result
Antiplatelet and Anticoagulant Therapy for Stroke Prevention in Patients With Non-Valvular Atrial Fibrillation: Evidence Based Strategies and New Developments
Gersh, B. J., Freedman, J. E., & Granger, C. B. (2011) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2011.01.001 · Cited by 13
Effects of Direct Oral Anticoagulants on Quality of Life During Periprocedural Management for Dental Extractions
Cabbar, F., Cabbar, A. T., Coşansu, K., & Çekirdekçi, E. İ. (2018) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2018.11.032 · Cited by 13
Outcomes and Safety of Antithrombotic Treatment in Patients Aged 80 Years or Older With Nonvalvular Atrial Fibrillation
Ortiz, M. R., Romo, E., Mesa, D., Delgado, M., Ibáñez, C. L., Anguita, M. P., Castillo, J. C., Arizón, J. M., & de Lezo, J. S. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.01.025 · Cited by 13
Bleeding Risk and Major Adverse Events in Patients With Previous Ulcer on Oral Anticoagulation Therapy
Lee, S., Shin, D., Hwang, H.-J., Kim, J., Pak, H., Lee, M., & Joung, B. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2012.03.036 · Cited by 13
Promoting Cardiovascular and Cerebrovascular Health
Fuster, V., & Bansilal, S. (2010) · Stroke · doi:10.1161/strokeaha.110.587709 · Cited by 13
Fatal Association of Mechanical Valve Thrombosis With Dabigatran
Atar, S., Wishniak, A., Shturman, A., Shtiwi, S., & Brezins, M. (2013) · CHEST Journal · doi:10.1378/chest.12-2486 · Cited by 13
Troponin-I Is a Predictor of a Delayed Diagnosis of Atrial Fibrillation in Acute Ischemic Stroke and Transient Ischemic Attack
Ward, F., McGovern, R., & Cotter, P. E. (2014) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2014.07.038 · Cited by 13
Common flaws exist in published cost-effectiveness models of pharmacologic stroke prevention in atrial fibrillation
Limone, B. L., Baker, W. L., Mearns, E. S., White, C. M., Kluger, J., & Coleman, C. I. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2014.05.013 · Cited by 13
Evidence-Based Percutaneous Closure of the Left Atrial Appendage in Patients with Atrial Fibrillation
Leal, S., Moreno, R., Almeida, M., Silva, J. A., & López-Sendón, J. L. (2012) · Current Cardiology Reviews · doi:10.2174/157340312801215827 · Cited by 13
Avances en la prevención de la isquemia cerebral por fibrilación auricular
Núñez, A. G. (2010) · Neurología · doi:10.1016/j.nrl.2010.03.008 · Cited by 13
Antithrombotic therapy in atrial fibrillation: aspirin is rarely the right choice
Sabir, I. N., Matthews, G. D. K., & Huang, C. L.-H. (2013) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2012-131386 · Cited by 13
La anticoagulación oral en el anciano con fibrilación auricular no valvular
Fernández, F. V., Jiménez, M. D. R. M., Cerviño, S. M. B., & Losada, M. D. M. M. (2015) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2015.01.005 · Cited by 13
Antithrombotic treatment for the primary prevention of stroke in patients with non valvular atrial fibrillation: A reappraisal of the evidence and network meta analysis
Owen, A. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.11.045 · Cited by 13
Aspirin plus clopidogrel versus aspirin mono-therapy for ischemic stroke: a meta-analysis
Ye, M.-B., Chen, Y., Wang, Q., An, J., Ye, F., & Jing, P. (2019) · Scandinavian Cardiovascular Journal · doi:10.1080/14017431.2019.1620962 · Cited by 13
“The addition of clopidogrel to aspirin has been shown to decrease the risk of stroke among patients with atrial fibrillation [13] and acute coronary syndromes [14], with several cases described in the recent literature.”
Background
Understanding Atrial Cardiopathy: an Under-Recognized Contributor to Cardioembolic Stroke
Johansen, M. C., Vasconcellos, H. D. D., & Gottesman, R. F. (2019) · Current Treatment Options in Neurology · doi:10.1007/s11940-019-0571-4 · Cited by 13
Timing to start anticoagulants after acute ischemic stroke with non-valvular atrial fibrillation
Albakr, A. I., AlOmar, R. S., Nada, M., Ishaque, N., Aljaafari, D., Hadhiah, K. M., Al-Khamis, F. A., Zafar, A. S., Shahid, R., Shariff, E., et al. (2019) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2019.116582 · Cited by 14
Prediction of Congestive Heart Failure in Patients with Non Valvular Atrial Fibrillation
Imai, K., Okura, H., Tamada, T., Fukuhara, K., Koyama, T., Kume, T., Hayashida, A., Kawamoto, T., Neishi, Y., & Yoshida, K. (2013) · Internal Medicine · doi:10.2169/internalmedicine.53.0962 · Cited by 13
Severe non-traumatic bleeding events detected by computed tomography: do anticoagulants and antiplatelet agents have a role?
Risch, O., Alfidja, A., Mulliez, A., Amani, A. H., Boyer, L., Camilleri, L., & Azarnoush, K. (2014) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-014-0166-9 · Cited by 13
Spotlight on idarucizumab and its potential for the reversal of anticoagulant effects of dabigatran
Siè, P. (2016) · Drug Design Development and Therapy · doi:10.2147/dddt.s94167 · Cited by 14
Prevalencia de fibrilación auricular y características de la fibrilación auricular no valvular en la población general. Registro AFINVA
Mora-Llabata, V., Dubois, D., Torres, I. R., Mateu-Navarro, C., Sanz-García, J. J., Moreno-Ballester, V., Mira-Gimeno, S., & Albiñana-Fernández, F. (2016) · Revista Colombiana de Cardiología · doi:10.1016/j.rccar.2016.03.021 · Cited by 13
Vascular Diseases of the Nervous System
Biller, J., Love, B. B., & Schneck, M. J. (2008) · Elsevier eBooks · doi:10.1016/b978-0-7506-7525-3.50069-8 · Cited by 13
All-Cause, Stroke-, and Bleed-Specific Healthcare Costs: Comparison among Patients with Non-Valvular Atrial Fibrillation (NVAF) Newly Treated with Dabigatran or Warfarin
Gilligan, A. M., Gandhi, P., Song, X., Wang, C., Henriques, C., Sander, S. D., & Smith, D. M. (2017) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-017-0244-1 · Cited by 14
EURASIAN ASSOCIATION OF CARDIOLOGY (EAC)/ NATIONAL SOCIETY OF HEART FAILURE AND MYOCARDIAL DISEASE (NSHFMD) GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF CHRONIC HEART FAILURE (2020)
Tereshchenko, S. N., Жиров, И. В., Uskach, T. M., Saidova, M. A., Sp, G., Михайловна, Г. Е., Николаевна, Н. С., Narusov, O. Y., Safiullina, A. A., Tereshchenko, A. S., et al. (2020) · Eurasian heart journal · doi:10.38109/2225-1685-2020-3-6-76 · Cited by 12
Anticoagulation Protocol for Secondary Prevention of Acute Ischemic Stroke Associated with Nonvalvular Atrial Fibrillation
Kimura, T., Tucker, A., Nakagaki, A., SUGIMURA, T., Fukuda, S., Katsuno, M., Fujita, T., Izumi, N., Suzuki, N., & Sako, K. (2021) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2021.105893 · Cited by 12
Single vs dual antiplatelet therapy after left atrial appendage closure: A propensity score matching analysis
Galea, R., Krsnik, J. P., Bini, T., Chalkou, K., Gasys, A., Brugger, N., Madhkour, R., Seiffge, D. J., Roten, L., Siontis, G. C. M., et al. (2025) · Heart Rhythm · doi:10.1016/j.hrthm.2024.12.007 · Cited by 12
Stroke Note
Chong, C. A. K. Y., & Chiu, L. (2010) · Cerebrovascular Diseases · doi:10.1159/000317110 · Cited by 12
Estudo FATA: Prevalência de Fibrilhação Auricular e Terapêutica Antitrombótica nos Cuidados de Saúde Primários de um Concelho do Norte de Portugal
Gomes, E. R., Campos, R., Morais, R., & Fernandes, M. (2015) · Acta Médica Portuguesa · doi:10.20344/amp.5503 · Cited by 12
Atrial Fibrillation in Long Term Care
Rich, M. W. (2012) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2012.07.009 · Cited by 11
Nuevos anticoagulantes orales
Lozano, F. S., Arcelus, J. I., & Monréal, M. (2010) · Angiología · doi:10.1016/s0003-3170(10)70007-9 · Cited by 12
Comparison of CHADS2 and CHA2DS2-VASC anticoagulation recommendations: evaluation in a cohort of atrial fibrillation ablation patients
Winkle, R. A., Mead, R. H., Engel, G., Kong, M. H., & Patrawala, R. A. (2013) · EP Europace · doi:10.1093/europace/eut244 · Cited by 12
Nonpharmacologic Approaches to Stroke Prevention in Atrial Fibrillation
Whitlock, R. P., Hanif, H., & Danter, M. R. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.04.004 · Cited by 12
Oral Antithrombotic Therapy in Atrial Fibrillation Associated With Acute or Chronic Coronary Artery Disease
Cairns, J. A., & McMurtry, M. S. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.04.006 · Cited by 12
Cardiac Procedures to Prevent Stroke: Patent Foramen Ovale Closure/Left Atrial Appendage Occlusion
Freixa, X., Arzamendi, D., Tzikas, A., Noble, S., Basmadjian, A., Garceau, P., & Ibrahim, R. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.11.008 · Cited by 12
Impact of stated barriers on proposed warfarin prescription for atrial fibrillation: a survey of Canadian physicians
Nicholls, S. G., Brehaut, J., Arım, R. G., Carroll, K. A., Perez, R., Shojania, K. G., Grimshaw, J., & Poses, R. M. (2014) · Thrombosis Journal · doi:10.1186/1477-9560-12-13 · Cited by 12
Changing anticoagulant paradigms for atrial fibrillation: dabigatran, apixaban and rivaroxaban
Giorgi, M. A., Arazi, H. C., González, C. D., & Girolamo, G. D. (2011) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2011.528754 · Cited by 12
Antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome in the real world: Data from the Berlin AFibACS Registry.
Maier, B., Hegenbarth, C., Theres, H., Schoeller, R., Schuehlen, H., & Behrens, S. (2014) · Cardiology Journal · doi:10.5603/cj.a2013.0146 · Cited by 13
Hierarchical models for multiple, rare outcomes using massive observational healthcare databases
Shaddox, T. R., Ryan, P. B., Schuemie, M. J., Madigan, D., & Suchard, M. A. (2016) · Statistical Analysis and Data Mining The ASA Data Science Journal · doi:10.1002/sam.11324 · Cited by 11
Anticoagulation risk assessment for patients with non-valvular atrial fibrillation and venous thromboembolism: A clinical review
Pallazola, V. A., Kapoor, R. K., Kapoor, K., McEvoy, J. W., Blumenthal, R. S., & Gluckman, T. J. (2019) · Vascular Medicine · doi:10.1177/1358863x18819816 · Cited by 14
The Importance of Appropriate Dosing of Nonvitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation
Beyer‐Westendorf, J., Fay, M., & Amara, W. (2021) · TH Open · doi:10.1055/s-0041-1731777 · Cited by 12
Antithrombotika und Antihämorrhagika
Hein, L., & Wille, H. (2019) · Springer eBooks · doi:10.1007/978-3-662-59046-1_19 · Cited by 12
Novos anticoagulantes em cuidados intensivos
Flato, U. A. P., Buhatem, T., Merluzzi, T., & Bianco, A. C. (2011) · Revista Brasileira de Terapia Intensiva · doi:10.1590/s0103-507x2011000100012 · Cited by 13
A Review of Oral Anticoagulants in Patients with Atrial Fibrillation
Greenspon, A. J. (2012) · Postgraduate Medicine · doi:10.3810/pgm.2012.11.2608 · Cited by 12
ADP Receptor Antagonists
Cattaneo, M. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-387837-3.00054-7 · Cited by 12
Neurología y cardiología: puntos de contacto
Goldstein, L. B., & Husseini, N. E. (2011) · Revista Española de Cardiología · doi:10.1016/j.recesp.2010.12.004 · Cited by 12
Clopidogrel vs. Aspirin Treatment on Admission Improves 5-Year Survival After a First-ever Acute Ischemic Stroke. Data from the Athens Stroke Outcome Project
Milionis, H. J., Gerotziafas, G., Kostapanos, M. S., Vemmou, A., Zis, P., Spengos, K. M., Elisaf, M., & Vemmos, K. N. (2011) · Archives of Medical Research · doi:10.1016/j.arcmed.2011.09.001 · Cited by 12
The atrial fibrillation epidemic is approaching the physician's door: will mobile technology improve detection?
Lindsberg, P. J., Toivonen, L. K., & Diener, H. (2014) · BMC Medicine · doi:10.1186/s12916-014-0180-8 · Cited by 12
Clopidogrel Added to Aspirin Adds No Benefit but Bleeding Risk in Patients With Recent Lacunar Stroke
Diener, H., & Weber, R. (2013) · Stroke · doi:10.1161/strokeaha.112.680751 · Cited by 12
Gastrointestinal comorbidities associated with atrial fibrillation
Laliberté, F., Moore, Y., Dea, K., LaMori, J. C., Mody, S. H., Jones, J. L., Arledge, M. D., Damaraju, C. V., Schein, J. R., & Lefèbvre, P. (2014) · SpringerPlus · doi:10.1186/2193-1801-3-603 · Cited by 12
“…codes) and the subset of GI events based on the classification in the recent Randomized Evaluation of Long-Term Anticoagulation (RE-LY) study (Connolly et al. 2009), including dyspepsia (including upper abdominal pain, abdominal pain, and abdominal discomfort, as well as dyspepsia),…”
Background
Stroke Prevention in Atrial Fibrillation: Where are We Now?
Ahmad, Y., & Lip, G. Y. H. (2012) · Clinical Medicine Insights Cardiology · doi:10.4137/cmc.s8976 · Cited by 12
Novel oral anticoagulants in plastic surgery
Munson, C. F., & Reid, A. J. (2016) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2016.02.011 · Cited by 12
Stroke prevention in atrial fibrillation
Mohammed, I., Mohmand-Borkowski, A., Burke, J. F., & Kowey, P. R. (2011) · Journal of Cardiovascular Medicine · doi:10.2459/jcm.0b013e32834f2336 · Cited by 12
Meta-analysis and adjusted indirect comparison of direct oral anticoagulants in prevention of acute limb ischemia in patients with atrial fibrillation
Haro, J. D., Bleda, S., Varela, C., Cañibano, C., & Acín, F. (2016) · Current Medical Research and Opinion · doi:10.1185/03007995.2016.1163256 · Cited by 12
Efficacy and Safety of Percutaneous Left Atrial Appendage Occlusion for Stroke Prevention in Nonvalvular Atrial Fibrillation: A Meta-analysis of Contemporary Studies
Xu, H., Xie, X., Wang, B., Ma, S., & Wang, F. (2016) · Heart Lung and Circulation · doi:10.1016/j.hlc.2016.03.016 · Cited by 12
“clopidogrel and aspirin was considered, even though the DAPT was prescribed for one to three months after the LAA occlusion [47].”
Background
Effectiveness and safety of drugs used for stroke prevention in a cohort of non‐valvular atrial fibrillation patients from a primary care electronic database
Giner‐Soriano, M., Roso‐Llorach, A., Urgell, C. V., Cervelló, X. C., Capellà, D., González, I. F., Elorza, J. M., Casajuana‐Closas, M., Troncoso‐Mariño, A., Diogène, E., et al. (2016) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.4137 · Cited by 12
Choosing Non-Vitamin K Antagonist Oral Anticoagulants: Practical Considerations We Need to Know.
Amin, A. (2016) · PubMed Central · Cited by 12
An Update on Anticoagulation in Atrial Fibrillation
Amerena, J. V., & Ridley, D. (2017) · Heart Lung and Circulation · doi:10.1016/j.hlc.2017.05.131 · Cited by 11
Dabigatran Levels in Elderly Patients with Atrial Fibrillation: First Post-Marketing Experiences
Bolek, T., Samoš, M., Škorňová, I., Stančiaková, L., Staško, J., Galajda, P., Kubisz, P., & Mokáň, M. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0552-4 · Cited by 12
Estimated Effectiveness and Safety of Nonvitamin K Antagonist Oral Anticoagulants Compared With Optimally Acenocoumarol Anticoagulated “Real-World” in Patients With Atrial Fibrillation
Esteve‐Pastor, M. A., Rivera‐Caravaca, J. M., Roldán, V., Orenes‐Piñero, E., Romiti, G. F., Romanazzi, I., Bai, Y., Carmo, J., Proietti, M., Marín, F. R., et al. (2018) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2018.05.012 · Cited by 12
Increasing use of anticoagulants in Germany and its impact on hospitalization for gastrointestinal bleeding
Guelker, J., Ilousis, D., Kröger, K., Santosa, F., Kowall, B., & Stang, A. (2019) · Thrombosis Research · doi:10.1016/j.thromres.2019.07.009 · Cited by 12
VE-1902—A direct thrombin inhibitor with reversible covalent mechanism of action shows efficacy with reduced bleeding in rodent models of thrombosis
Sivaraja, M., Clemens, D. M., Sizikov, S., Dash, S., Xu, C., Rienzo, M., Yang, B., Ryan, M. R., Chattopadhyay, M., Igoudin, L., et al. (2020) · Thrombosis Research · doi:10.1016/j.thromres.2020.04.020 · Cited by 12
“However, both single and dual anti-platelet therapies are inferior to anticoagulation in preventing stroke in patients with AF [6].”
Background
Cost-effectiveness analysis of apixaban compared to other direct oral anticoagulants for prevention of stroke in Austrian atrial fibrillation patients
Walter, E., Voit, M., & Eichhober, G. (2020) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2020.1798233 · Cited by 12
Current Therapeutic Approach to Atrial Fibrillation in Patients with Congenital Hemophilia
Bădescu, M. C., Bădulescu, O. V., Butnariu, L. I., Floria, M., Ciocoiu, M., Costache, I. I., Popescu, D., Bratoiu, I., Buliga-Finiș, O. N., & Rezuș, C. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12040519 · Cited by 12
“Adding clopidogrel to aspirin reduced the stroke rate compared to aspirin alone, but major bleedings significantly increased [113].”
Background
Cost-Effectiveness and Cost-Utility Analyses of Dabigatran Compared with Warfarin in Patients with Nonvalvular Atrial Fibrillation and Risk Factors for Stroke and Systemic Embolism within Brazilian Private and Public Health Care Systems Perspectives
de Souza, C. P. R., Santoni, N., de Melo, T. G., Figueiredo, M. J. D. O., Darrieux, F., Piegas, L. S., & Martins, S. C. O. (2015) · Value in Health Regional Issues · doi:10.1016/j.vhri.2015.02.003 · Cited by 11
Management of Atrial Fibrillation
Zamani, P. L., & Verdino, R. J. (2014) · Journal of Intensive Care Medicine · doi:10.1177/0885066614534603 · Cited by 12
“Finally, a recent trial compared the addition of clopidogrel to aspirin in patients for whom vitamin K antagonism was felt to be unsuitable.(135) Dual antiplatelet therapy did indeed reduce the incidence of stroke (2.”
Method
Cardioembolic Stroke: Practical Considerations for Patient Risk Management and Secondary Prevention
Amin, H., Nowak, R. J., & Schindler, J. (2014) · Postgraduate Medicine · doi:10.3810/pgm.2014.01.2725 · Cited by 12
Does type 2 diabetes affect the on-treatment levels of direct oral anticoagulants in patients with atrial fibrillation?
Samoš, M., Bolek, T., Stančiaková, L., Škorňová, I., Ivanková, J., Kovář, F., Galajda, P., Kubisz, P., Staško, J., & Mokáň, M. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.11.024 · Cited by 12
Novel Oral Anticoagulants
Spahn, D. R., & Korte, W. C. (2011) · Anesthesiology · doi:10.1097/aln.0b013e318238c070 · Cited by 12
Temporary omission of oral anticoagulation in atrial fibrillation patients undergoing percutaneous coronary intervention: rationale and design of the WOEST-3 randomised trial
Verburg, A., Bor, W. L., Küçük, I. T., Henriques, J. P. S., Vink, M. A., Ruifrok, W.-P. T., Plomp, J., Heestermans, T. A. C. M., Schotborgh, C. E., Vlaar, P. J. J., et al. (2024) · EuroIntervention · doi:10.4244/eij-d-24-00100 · Cited by 12
Novedades en electrofisiología cardiaca y arritmias
Hernández‐Madrid, A., Francés, R. M., & Moro, C. (2011) · Revista Española de Cardiología · doi:10.1016/s0300-8932(11)70011-2 · Cited by 11
Combination Aspirin and Clopidogrel for Secondary Prevention of Ischemic Stroke
Field, T. S., Nakajima, M., & Benavente, O. (2013) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-013-0241-x · Cited by 11
Practice Implications of the Atrial Fibrillation Guidelines
Curtis, A. B. (2013) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2013.01.338 · Cited by 11
“The basis for this recommendation was the results from the Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE W) and Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation (ACTIVE A) trials.(28,29) The results of the ACTIVE W trial indicate that oral an…”
Result
Antiplatelet therapy in secondary stroke prevention – state of the art
Diener, H., Weimar, C., & Weber, R. (2010) · Journal of Cellular and Molecular Medicine · doi:10.1111/j.1582-4934.2010.01163.x · Cited by 12
Aspirin versus vitamin K antagonist treatment guided by transoesophageal echocardiography in patients with atrial fibrillation: a pilot study
Dinh, T., Baur, L. H. B., Pisters, R., Otto Kamp, B., Verheugt, F. W. A., Smeets, J. L. R. M., Cheriex, E. C., Lindeboom, J.-E., Heesen, W. F., Tieleman, R. G., et al. (2014) · Heart · doi:10.1136/heartjnl-2013-305017 · Cited by 11
Usefulness of the SAME-TT2R2 score to predict anticoagulation control on VKA in patients with atrial fibrillation and obstructive sleep apnea
Szymański, F. M., Lip, G. Y. H., Filipiak, K. J., Platek, A. E., & Karpiński, G. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.11.158 · Cited by 11
Left atrial appendage closure: An emerging option in atrial fibrillation when oral anticoagulants are not tolerated
Peritz, D. C., & Chung, E. H. (2015) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.82a.14117 · Cited by 11
Anticoagulation for stroke prevention in elderly patients with non-valvular atrial fibrillation: what are the obstacles?
Wong, C. (2016) · Hong Kong Medical Journal · doi:10.12809/hkmj154803 · Cited by 11
2019 ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD
Cosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz486 · Cited by 4,763
Standard versus atrial fibrillation-specific management strategy (SAFETY) to reduce recurrent admission and prolong survival: pragmatic, multicentre, randomised controlled trial
Stewart, S., Ball, J., Horowitz, J. D., Marwick, T. H., Mahadevan, G., Wong, C., Abhayaratna, W. P., Chan, Y. K., Esterman, A., Thompson, D. R., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(14)61992-9 · Cited by 147

Authors: The ACTIVE Investigators
Affiliations: Population Health Research Institute (CA)
Corresponding author: The ACTIVE Investigators
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2009-05-14
Volume: 360
Issue: 20
Pages: 2066-2078
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa0901301
OpenAlex: W2113089341
Cited by: 2,102
References: 25
Citations by year: 2026: 10 · 2025: 16 · 2024: 25 · 2023: 19 · 2022: 23 · 2021: 55 · 2020: 65 · 2019: 73 · 2018: 75 · 2017: 115 · 2016: 166 · 2015: 205 · 2014: 209 · 2013: 264 · 2012: 286
FWCI: 168.46
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
HAL (submittedVersion)
ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
Own your potential (DEAKIN) (submittedVersion)
Figshare (submittedVersion, cc-by)
University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion)
UnissResearch (Università degli Studi di Sassari) (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
Keywords: clopidogrel, aspirin, atrial fibrillation, stroke prevention, antiplatelet therapy, vitamin K antagonists, myocardial infarction, major bleeding, vascular events, systemic embolism, anticoagulation alternatives, bleeding risk, stroke risk reduction, quality of life, cost-effectiveness
MeSH terms: Clopidogrel, Aged, Aspirin, Atrial Fibrillation, Double-Blind Method, Drug Therapy, Combination, Embolism, Female, Follow-Up Studies, Hemorrhage, Humans, Male, Middle Aged, Myocardial Infarction, Platelet Aggregation Inhibitors, Risk, Ticlopidine, Vascular Diseases, Vitamin K, Incidence, Stroke

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks