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Adding Clopidogrel to Aspirin Reduces Cardiac Risk

But risk of major bleeding higher than with aspirin alone

WEDNESDAY, April 2 (HealthDay News) -- Treatment with aspirin plus clopidogrel reduces the risk of major cardiovascular events in high-risk patients but has no effect on mortality compared with aspirin alone, although the risk of major bleeding is much higher with combination treatment, according to the results of a study published in the April 1 issue of the American Journal of Cardiology.

Ashna D.K. Bowry, and colleagues from Brigham and Women's Hospital and Harvard Medical School in Boston, performed a meta-analysis of eight randomized, controlled trials involving 91,744 patients comparing aspirin alone to aspirin plus clopidogrel.

The researchers found that combination treatment reduced the risk of death, infarction and stroke by 15 percent in patients with acute coronary syndromes and by 34 percent in patients who underwent percutaneous coronary intervention. Combination treatment also reduced the likelihood of fatal and non-fatal reinfarction in these patients, but had no significant effect on all-cause mortality, the report indicates. However, the investigators note, the risk of major bleeding was significantly higher in patients receiving combination therapy for more than one month (odds ratio 1.80).

"In conclusion, combining aspirin and clopidogrel significantly reduces the odds of major cardiovascular events in patients with acute coronary syndromes or those who undergo percutaneous coronary intervention but at the expense of significant increases in the risk for bleeding," Bowry and colleagues write.

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