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.

Insights

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.

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