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Clopidogrel plus aspirin did not differ from aspirin alone for reducing MI, stroke, and CV death in high risk atherothrombosis

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 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?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Neurology ★★★★★★☆ Cardiology ★★★★★★☆

METHODS

Embedded ImageDesign:

randomised placebo controlled trial (Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilisation, Management, and Avoidance [CHARISMA]).

Embedded ImageAllocation:

concealed.*

Embedded ImageBlinding:

blinded {clinicians, patients, data collectors, outcome assessors, data analysts, and data safety and monitoring committee}.*

Embedded ImageFollow up period:

median 28 months.

Embedded ImageSetting:

768 sites in 32 countries.

Embedded ImagePatients:

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 …

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