Clopidogrel Beats Aspirin at 10 Years Post-PCI

Clinical Takeaway

: Clopidogrel remained superior over the long term, with fewer ischemic events and bleeding episodes.

Context

Lifelong antiplatelet monotherapy is recommended for patients who’ve completed dual antiplatelet therapy (DAPT) after undergoing percutaneous coronary intervention (PCI). Aspirin has traditionally been the treatment of choice in this setting, but clopidogrel has repeatedly been shown to be more effective, at least for the first 3 to 5 years after DAPT. Now, researchers report 10-year outcomes from a large, multicenter, randomized trial in Korea that compared the two agents ().

Key Results

Clopidogrel led to a significantly lower rate of the primary composite end point — death, ischemic events, and bleeding — than aspirin (25% vs. 28%); 33 patients would need to be treated to prevent one primary event.
The benefit was due to both…

Reviewing Author

Howard C. Herrmann, M.D.

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

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)