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Clopidogrel plus aspirin was effective but increased bleeding in acute coronary syndromes without ST-segment elevation

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 QUESTION: What is the efficacy and safety of early and long term use of clopidogrel plus aspirin and aspirin alone in patients with acute coronary syndromes without ST-segment elevation?


Randomised (allocation concealed*), blinded {patients, healthcare providers, data collectors, outcome assessors, monitoring committee, statisticians, and manuscript writers},* placebo controlled trial with 12 months of follow up (Clopidogrel in Unstable Angina to Prevent Recurrent Events [CURE] Trial).


482 centres in 28 countries.


12 562 patients (mean age 64 y, 62% men) who were admitted to hospital within 24 hours of symptom onset, had either electrocardiographic changes or elevated concentrations of cardiac enzymes, and did not have ST-segment elevation. Exclusion criteria were contraindications to antithrombotic or antiplatelet treatment, high risk …

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  • * See glossary.

  • Information provided by author.

  • Sources of funding: Sanofi-Synthelabo and Bristol-Myers Squibb.

  • For correspondence: Dr S Yusuf, Hamilton General Hospital, Hamilton, Ontario, Canada. yusuf{at}