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Comparative effect of clopidogrel and aspirin versus aspirin alone on laboratory parameters: a retrospective,

Yasuo Takahashi, Yayoi Nishida, Tomohiro Nakayama

    Cardiovascular Diabetology
    |June 18, 2013
    PubMed

    Insights

    Combination therapy with clopidogrel and aspirin may lead to greater hematological adverse effects, specifically a reduction in white blood cell count, compared to aspirin monotherapy. This study evaluated laboratory parameters in patients receiving these antiplatelet agents.

    Area of Science:

    • Cardiovascular Medicine
    • Pharmacology
    • Clinical Laboratory Science

    Background:

    • Clopidogrel and aspirin are crucial antiplatelet agents for preventing recurrent cardiovascular events.
    • Combination therapy increases hemorrhage risk, but its impact on laboratory parameters requires further study in clinical practice.

    Purpose of the Study:

    • To compare the effects of clopidogrel plus aspirin versus aspirin monotherapy on laboratory parameters.
    • To assess changes in serum levels and hematological parameters in patients undergoing antiplatelet therapy.

    Main Methods:

    • Retrospective analysis of 159 clopidogrel/aspirin users and 834 aspirin monotherapy users from November 2004 to April 2011.
    • Multivariable regression and propensity score adjustment were used to compare mean changes in laboratory values.
    • Evaluated serum creatinine, liver enzymes, hemoglobin, hematocrit, and various blood cell counts up to two months post-initiation.

    Main Results:

    • Combination therapy showed a significantly greater reduction in white blood cell (WBC) count compared to aspirin alone.
    • No other statistically significant differences were observed in other tested laboratory parameters between the groups.
    • Clopidogrel plus aspirin increased the risk of gastrointestinal bleeding (RR 2.06-2.61).

    Conclusions:

    • Hematological adverse effects, particularly decreased WBC count, may be more pronounced with clopidogrel and aspirin combination therapy.
    • Findings suggest careful monitoring of laboratory parameters in patients on dual antiplatelet therapy.
    Abstract

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