Effect of addition of clopidogrel to aspirin on stroke incidence: Meta-analysis of randomized trials

International Journal of Stroke

Volumn 10, Issue 5, 2015, Pages 686-691

  Palacio, Santiago ^a   Hart, Robert G ^b   Pearce, Lesly A ^c   Anderson, David C ^d   Sharma, Mukul ^b   Birnbaum, Lee A ^a   Benavente, Oscar R ^e  

^a UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO   (United States)

^b MCMASTER UNIVERSITY   (Canada)

^c Biostatistical Consulting   (United States)

^d UNIVERSITY OF MINNESOTA   (United States)

^e UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

Antiplatelet therapy; Clinical trials; Clopidogrel; Stroke

Indexed keywords

ACETYLSALICYLIC ACID; CLOPIDOGREL; ANTITHROMBOCYTIC AGENT; TICLOPIDINE;

ARTICLE; BLEEDING; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CEREBROVASCULAR ACCIDENT; COMBINATION CHEMOTHERAPY; DRUG EFFECT; DRUG EFFICACY; FOLLOW UP; HUMAN; INCIDENCE; META ANALYSIS; MONOTHERAPY; PATIENT RISK; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK REDUCTION; SYSTEMATIC REVIEW; VASCULAR DISEASE; AGED; ANALOGS AND DERIVATIVES; COMBINATION DRUG THERAPY; FEMALE; MALE; MIDDLE AGED; STROKE;

AGED; ASPIRIN; DRUG THERAPY, COMBINATION; FEMALE; HUMANS; INCIDENCE; MALE; MIDDLE AGED; PLATELET AGGREGATION INHIBITORS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; STROKE; TICLOPIDINE;

EID: 84931572657     PISSN: 17474930     EISSN: 17474949     Source Type: Journal    
DOI: 10.1111/ijs.12050     Document Type: Article

References (24)

1. Palacio S, Hart RG, Pearce LA, Benavente O. Effect of addition of clopidogrel to aspirin on mortality: systematic review of randomized trials. Stroke 2012; 43:2157-2162.
2. Jadad A, Moore R, Carroll D etal. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17:1-12.
3. Reviewer Manager (RevMan) (Computer Program). Version 5.0. Copenhagen, The Nordic Cochrane Center, the Cochrane Collaboration, 2008.
4. Connolly SJ, Pogue J, Hart RG etal. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 2009; 360:2066-2078.
5. Bhatt DL, Fox KA, Hacke E etal. Clopidogrel plus aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354:1706-1717.
6. Willerson T, Cable G, Yeh E on behalf of the PROCLAIM Investigators. Pilot study to examine the effects of clopidogrel on inflammatory markers in patients with metabolic syndrome receiving low-dose aspirin (PROCLAIM). Tex Heart Inst J 2009; 36:530-539.
7. Park S-J, Park D-W, Kim Y-H etal. Duration of dual antiplatelet therapy after implantation of drug-eluting stents. N Engl J Med 2010; 362:1374-1382.
8. The SPS3 Investigators. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N Engl J Med 2012; 367:817-825.
9. Markus HS, Droste DW, Kaps M etal. Dual antiplatelet therapy with clopidogrel and aspirin in symptomatic carotid stenosis evaluated using Doppler embolic signal detection. The Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic Carotid Stenosis (CARESS) trial. Circulation 2005; 111:2233-2240.
10. Wong KS, Chen C, Fu J etal. Clopidogrel plus aspirin versus aspirin alone for reducing embolisation in patients with acute symptomatic cerebral or carotid artery stenosis (CLAIR study): a randomised, open-label, blinded-endpoint trial. Lancet Neurol 2010; 9:489-497.
11. Chen ZM, Jiang LX, Chen YP etal. Addition of clopidogrel to aspirin in 45852 patients with acute myocardial infarction: randomized placebo-controlled trial (COMMIT). Lancet 2005; 366:1607-1621.
12. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognomi G, Fox KK, Clopidogrel in Unstable angina to prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes with ST-segment elevations. N Engl J Med 2001; 345:494-502.
13. Kennedy J, Hill MD, Ryckborst KJ, Eliasziw M, Demchuck AM, Buchan AM for the FASTER Investigators. Fast assessment of stroke and transient ischemic attack to prevent early recurrence (FASTER): a randomized controlled pilot trial. Lancet Neurol 2007; 6:961-969.
14. Kulik A, Le May MR, Voisine P etal. Aspirin plus clopidogrel versus aspirin alone after coronary artery bypass grafting. Clopidogrel after Surgery for Coronary Artery Disease (CASCADE) Trial. Circulation 2010; 122:2680-2687.
15. Cassar K, Ford I, Greaves M, Bachoo P, Brittenden J. Randomized clinical trial of the antiplatelet effects of aspirin-clopidogrel combination versus aspirin alone after lower limb angioplasty. Br J Surg 2005; 92:159-165.
16. Steinhubl SR, Berger PB, Mann JT III etal. for the CREDO Investigators. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002; 288:2411-2420.
17. Hankey GJ, Johnston C, Easton D etal. Effect of clopidogrel plus ASA vs. ASA early after TIA and ischaemic stroke: a substudy of the CHARISMA trial. Int J Stroke 2011; 6:3-9.
18. Mehta S, Tanguay J, Eikelboom J etal. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial. Lancet 2010; 376:1233-1243.
19. Johnston C. Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial. NCT00991029. Last updated on 23 January 2012. Available at http://www.clinicaltrials.gov (accessed 12 March 2012).
20. Wang Y, Johnston C for CHANCE Investigators. Rationale and design of a randomized, double-blind trial comparing the effects of a 3 month clopidogrel-aspirin regimen versus aspirin alone for the treatment of high-risk patients with acute nondisabling cerebrovascular event. Am Heart J 2010; 160:380-386.e.1.
21. Diener HC, Bogousslavsky J, Brass L etal. Aspirin and clopidogrel compared to clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomized, double blind, placebo-controlled trial. Lancet 2004; 364:331-337.
22. Furie KL, Kasner SE, Adams RJ etal. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for health professionals from the American Heart Association/American Stroke Association. Stroke 2011; 42:227-276.
23. CAPRIE Steering Committee. A randomized, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events. Lancet 1996; 9038:1329-1339.
24. Geeganage CM, Diener HC, Algra A etal. Dual or mono antiplatelet therapy for patients with acute ischemic stroke or transient ischemic attack. Systematic review and meta-analysis of randomized controlled trials. Stroke 2012; 43:1058-1066.