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Clopidogrel reduces the risk for cardiovascular events after acute coronary syndromes, but it is unknown whether clopidogrel cessation might provoke a “rebound” phenomenon (a clustered increase in events) similar to that observed upon discontinuation of aspirin or heparin. To explore this possibility, investigators retrospectively assessed the rates of adverse events in U.S. veterans who had been discharged from 127 Veterans Affairs hospitals after ACS and who received postdischarge treatment with clopidogrel.
Of 1568 patients who had received only medical treatment for ACS, subsequent death or acute MI occurred in 17.1%, and the preponderance of events (60.8%) occurred in the first 90 days after stopping clopidogrel therapy. Of 1569 patient…