Therapeutics
Clopidogrel plus aspirin did not differ from aspirin alone for reducing MI, stroke, and CV death in high risk atherothrombosis
Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006;354:1706–17.
Q In patients with high risk atherothrombosis, is long term treatment with clopidogrel plus aspirin more effective than aspirin alone for reducing cardiovascular (CV) events?
IM/Ambulatory care Internal medicine Neurology Cardiology
Key Words: aspirin • cardiovascular diseases • platelet aggregation inhibitors • thrombosis • ticlopidine
| The first 150 words of the full text of this article appear below. |
Design:
randomised placebo controlled trial (Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilisation, Management, and Avoidance [CHARISMA]).
Allocation:
concealed.*
Blinding:
blinded {clinicians, patients, data collectors, outcome assessors, data analysts, and data safety and monitoring committee}
.*
Follow up period:
median 28 months.
Setting:
768 sites in 32 countries.
Patients:
15 603 patients 
45 years of age (median age 64 y, 70% men, 80% white) who had multiple atherothrombotic risk factors (type 1 or 2 diabetes, diabetic nephropathy, ankle brachial index <0.9, asymptomatic carotid stenosis 70% of luminal diameter, 1 carotid plaque, systolic blood pressure 150 mm Hg, primary hypercholesterolaemia, smoking >15 cigarettes/d, or men 65 y or women 70 y of age), coronary disease, cerebrovascular disease, or symptomatic peripheral arterial disease. Exclusion criteria were long term use of antithrombotic or non-steroidal anti-inflammatory drugs, indications for clopidogrel therapy, or revascularisation.
Intervention:
clopidogrel, 75 mg/day, plus aspirin, 75–162 mg/day (n = 7802),
University of Virginia, Charlottesville, Virginia, USA
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Evid. Based Med. 2006 11: 159a. (in Glossary)[Extract] [Full Text] [PDF]
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