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- W52603669 abstract "Antiplatelet agents including aspirin and clopidogrel have an established role in reducing the risk of death, stroke and myocardial infarction, and other complications of cardiovascular disease. Aspirin is the standard acute and long-term antiplatelet agent, although clopidogrel alone is slightly more effective than aspirin alone. Several randomized trials have tested the effects of clopidogrel added to aspirin compared to aspirin alone and beneficial effects in the region of 10–20% proportional reductions in risk have been observed in acute coronary syndromes (ST-elevation and non-ST-elevation) and percutaneous coronary intervention. In the chronic setting, where there are far more patients who could potentially benefit, there has been no proven effect of adding clopidogrel to aspirin compared to aspirin alone. In the CHARISMA trial there were trends to benefit in subgroups with pre-existing vascular disease or a prior vascular event. The combination of clopidogrel plus aspirin compared to aspirin alone increases the risk of major bleeding by about 30%. A simple pooling of published data suggests that the overall benefit of adding clopidogrel to aspirin in patients with acute or chronic vascular disease decreases the risk of cardiovascular death, myocardial infarction, and stroke by a proportional 10% and an absolute 1% (with greater effects in higher-risk patients) which is clinically worthwhile. Further work is needed to test the effects of clopidogrel when added to aspirin in patients with a prior stroke, myocardial infarction, or peripheral arterial disease as there may be worthwhile benefits that were not apparent in the CHARISMA trial." @default.
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- W52603669 date "2009-08-31" @default.
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- W52603669 title "Thienopyridines in Stable Coronary Disease" @default.
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- W52603669 doi "https://doi.org/10.1007/978-1-60327-235-3_6" @default.
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