Is clopidogrel superior to aspirin in secondary prevention of vascular disease?

Related Experiment Video

Updated: Feb 10, 2026

Isolation of Intrapulmonary Artery and Smooth Muscle Cells to Investigate Vascular Responses
07:56

Isolation of Intrapulmonary Artery and Smooth Muscle Cells to Investigate Vascular Responses

Published on: June 8, 2022

4.9K

Ale Algra1, Jan van Gijn

  • 1University Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. A.Algra@neuro.azu.nl

Current Controlled Trials in Cardiovascular Medicine
|November 21, 2001
PubMed

Insights

Clopidogrel offers modest benefits for secondary vascular event prevention, particularly in peripheral arterial disease. While generally safe, rare thrombotic thrombocytopenic purpura cases warrant caution.

Area of Science:

  • Pharmacology and Clinical Medicine
  • Cardiovascular Disease Prevention

Background:

  • Thienopyridines, including clopidogrel and ticlopidine, are used for secondary prevention of vascular disease.
  • Comparing their efficacy and safety against aspirin is crucial for clinical decision-making.

Purpose of the Study:

  • To evaluate the relative efficacy of clopidogrel and ticlopidine versus aspirin in secondary vascular disease prevention.
  • To assess the safety profiles of these antiplatelet agents.

Main Methods:

  • Analysis of the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events (CURE) trial data.
  • Stratification of results based on qualifying vascular disorders: myocardial infarction, ischemic stroke, and peripheral arterial disease.

Main Results:

  • Clopidogrel demonstrated a modest overall benefit in reducing vascular events compared to aspirin.
  • Efficacy varied by condition: significant benefit in peripheral arterial disease (+23.8%), neutral in ischemic stroke (+7.3%), and potential harm in myocardial infarction (-3.7%).
  • Ticlopidine showed similar trends after brain ischemia; clopidogrel's safety profile was comparable to aspirin but superior to ticlopidine, barring rare thrombotic thrombocytopenic purpura (TTP) events.

Conclusions:

  • Clopidogrel provides a modest benefit in secondary vascular event prevention, with notable efficacy in peripheral arterial disease.
  • The differential efficacy across various vascular conditions necessitates careful patient selection.
  • While generally safe, the risk of thrombotic thrombocytopenic purpura associated with clopidogrel requires ongoing vigilance.

More Related Videos

Assessment of Vascular Function in Patients With Chronic Kidney Disease08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.8K
Orthotopic Aortic Transplantation in Mice for the Study of Vascular Disease09:06

Orthotopic Aortic Transplantation in Mice for the Study of Vascular Disease

Published on: November 28, 2012

11.4K

Related Concept Videos

Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
728
Primary and Secondary Growth in Roots and Shoots03:02

Primary and Secondary Growth in Roots and Shoots

Vascular plants, which account for over 90% of the Earth’s vegetation, all undergo primary growth—which lengthens roots and shoots. Many land plants, notably woody plants, also undergo secondary growth—which thickens roots and shoots.
60.6K
Secondary Active Transport01:55

Secondary Active Transport

One example of how cells use the energy contained in electrochemical gradients is demonstrated by glucose transport into cells. The ion vital to this process is sodium (Na+), which is typically present in higher concentrations extracellularly than in the cytosol. Such a concentration difference is due, in part, to the action of an enzyme “pump” embedded in the cellular membrane that actively expels Na+ from a cell. Importantly, as this pump contributes to the high concentration of...
138.1K
Secondary Active Transport01:32

Secondary Active Transport

One example of how cells use the energy contained in electrochemical gradients is demonstrated by glucose transport into cells. The ion vital to this process is sodium (Na+), which is typically present in higher concentrations extracellularly than in the cytosol. Such a concentration difference is due, in part, to the action of an enzyme "pump" embedded in the cellular membrane that actively expels Na+ from a cell. Importantly, as this pump contributes to the high concentration of...
9.7K
Seedless Vascular Plants03:24

Seedless Vascular Plants

Seedless Vascular Plants Were the First Tall Plants on Earth
67.3K
Secondary Healthcare System01:11

Secondary Healthcare System

Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
2.1K