Abstract | BACKGROUND AND PURPOSE: METHODS: Randomized trials in which clopidogrel was added to aspirin in subjects with vascular disease or vascular risk factors were identified. Trials were restricted to those with a mean follow-up of ≥14 days in which both the combination of aspirin and clopidogrel was tested and mortality was reported. RESULTS: Twelve trials included 90 934 participants (mean age, 63 years; 70% men; median follow-up, 1 year) with 6849 observed deaths. There was no significant increase in mortality with the combination therapy either in 4 short-term (14 days-3 months; OR, 0.93; 95% CI, 0.87-0.99) or in 7 long-term (>3 months; hazard ratio, 0.97; 95% CI, 0.91-1.04) trials after 1 long-term trial (the SPS3 trial) was excluded because of heterogeneity. Addition of clopidogrel was associated with an increase in fatal hemorrhage (OR, 1.35; 95% CI, 0.97-1.90) and a reduction in myocardial infarction (OR, 0.82; 95% CI, 0.74-0.91). CONCLUSIONS: CLINICAL TRIAL REGISTRATION: URL: http//www.clinicaltrials.gov. Unique identifier: NCT00059306.
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Authors | Santiago Palacio, Robert G Hart, Lesly A Pearce, Oscar R Benavente |
Journal | Stroke
(Stroke)
Vol. 43
Issue 8
Pg. 2157-62
(Aug 2012)
ISSN: 1524-4628 [Electronic] United States |
PMID | 22826359
(Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Review, Systematic Review)
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Chemical References |
- Platelet Aggregation Inhibitors
- Clopidogrel
- Ticlopidine
- Aspirin
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Topics |
- Adult
- Aged
- Aspirin
(therapeutic use)
- Cause of Death
- Cerebral Hemorrhage
(mortality)
- Clopidogrel
- Data Interpretation, Statistical
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Hemorrhage
(mortality)
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(mortality, prevention & control)
- Platelet Aggregation Inhibitors
(therapeutic use)
- Randomized Controlled Trials as Topic
- Ticlopidine
(analogs & derivatives, therapeutic use)
- Treatment Outcome
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