Summary: Evaluated 15,603 patients with documented coronary disease or risk equivalents with aspirin alone or aspirin plus clopidogrel for secondary prevention. The primary composite endpoint of MI, stroke and death was no different in the two groups. There was a significant benefit in the secondary endpoint which was reduction of hospitalization for ischemic events. Aspirin and clopidogrel had a significant increase in moderate bleeding and a trend towards an increase of severe bleeding (did not reach statistical significance). Concluded that aspirin alone should be used for secondary prevention of acute coronary syndromes, stroke and death in patients with coronary artery disease or risk equivalents.

Original Publication:

N Engl J Med 2006; 354:1706-1717

Eponym: Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance Trial