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Long-term combination therapy with aspirin and clopidogrel
C R Kumana1, Giselle Cheung, I J Lauder
1Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Journal of Cardiovascular Pharmacology and Therapeutics
|January 29, 2005
Summary
Combining aspirin and clopidogrel offers no overall advantage over single anti-platelet therapy for preventing cardiovascular events, despite potential bleeding risks. This analysis reviewed CURE and MATCH trial data for high-risk patients.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Aspirin and clopidogrel are antiplatelet agents used to prevent atherothrombotic events.
- Previous studies like CURE and MATCH explored their combined use.
Purpose of the Study:
- To evaluate the absolute benefits and harms of combined aspirin and clopidogrel therapy versus monotherapy.
- To determine the number needed to treat (NNT) per year for adverse cardiovascular outcomes and major bleeding.
Main Methods:
- Analysis of data from the CURE and MATCH clinical trials.
- Calculation of NNT per year for primary composite cardiovascular outcomes and major bleeding events.
Main Results:
- Combination therapy prevented one adverse cardiovascular outcome in 35-204 treated patients annually.
- Approximately 1 in 63 patients on combination therapy experienced major bleeding annually.
- No significant overall advantage was found for combination therapy over monotherapy.
Conclusions:
- Current evidence suggests no net benefit of combining aspirin and clopidogrel compared to using either agent alone.
- The risk of major bleeding associated with combination therapy may outweigh its benefits.