Therapeutics
Clopidogrel plus aspirin was inferior to oral anticoagulation for preventing vascular events in atrial fibrillation
The ACTIVE Writing Group on behalf of the ACTIVE Investigators; Connolly S, Pogue J, Hart R, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006;367:1903–12.[CrossRef][Medline]
Q In patients with atrial fibrillation (AF), is clopidogrel plus aspirin non-inferior to oral anticoagulation for preventing vascular events?
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. |
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
Carolinas Medical Center, Charlotte, North Carolina, USA
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