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Clopidogrel plus aspirin was inferior to oral anticoagulation for preventing vascular events in atrial fibrillation

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Cardiology Haematology

Key Words: anticoagulants • aspirin • atrial fibrillation • cerebrovascular accident • platelet aggregation inhibitors • biphenyl compounds • tetrazoles • ticlopidine

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial (Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events [ACTIVE W]).

Allocation: concealed.^*

Blinding: blinded (outcome assessors and monitoring committee).^*

Follow up period: median 1.28 years.

Setting: 30 clinical centres worldwide.

Patients: 6706 patients (mean age 70 y, 66% men) with AF and 1 of the following criteria: age 75 years; receiving treatment for systemic hypertension; previous stroke, transient ischaemic attack, or non-central nervous system (non-CNS) systemic embolus; left ventricular dysfunction with left ventricular ejection fraction <45%; peripheral arterial disease; or age 55–74 years with diabetes mellitus requiring drug therapy or previous coronary artery disease. Exclusion criteria were contraindication to clopidogrel or oral anticoagulant, documented peptic ulcer disease within the previous 6 months, previous intracerebral haemorrhage, significant thrombocytopenia, or mitral stenosis.

Intervention: clopidogrel, 75 mg/day plus aspirin, 75–100 mg/day (n = 3335), or oral anticoagulation (n = 3371). Patients in the oral anticoagulation group . . . [Full text of this article]

Michael A Sloan, MD, MS

Carolinas Medical Center, Charlotte, North Carolina, USA

Relevant Article

Glossary
Evid. Based Med. 2006 11: 191. (in Glossary) [Extract] [Full Text] [PDF]