Clopidogrel Before Percutaneous Coronary Intervention Confers a Modest Benefit

A meta-analysis fails to show a reduction in mortality but confirms a significant improvement in risk for major cardiovascular events.

Most studies that have demonstrated a benefit of clopidogrel pretreatment in patients with acute coronary syndromes undergoing invasive evaluation and treatment were underpowered for mortality. To examine the effects of clopidogrel pretreatment on mortality and other endpoints, investigators conducted a meta-analysis of seven randomized trials (8608 patients) and confirmatory meta-analyses of two observational subgroup analyses within randomized trials (10,945 patients) and six registry studies (18,261 patients).

In the randomized trial analysis, clopidogrel pretreatment was not associated with a reduction in all-cause mortality compared with no pretreatment (odds ratio, 0.80; 95% confidence interval, 0.57–1.11; P=0.17) or cardiovascular dea…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI