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The (Variable) Definition of Benefit in the Case of Clopidogrel vs Aspirin
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I have recently read "Comparative Benefits of Clopidogrel and Aspirin in High-Risk Patient Populations by Hirsh and Bhatt.1 I chose to compare those lessons learned with a relevant chapter in the Seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy.2
In their article, Hirsh and Bhatt1 review the Clopidogrel vs Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial data and conclude that, compared with aspirin, clopidogrel is superior in outcomes in subsets of patients (those with history of coronary artery bypass grafting, history of >1 ischemic event, involvement of multiple vascular beds, diabetes, and hypercholesterolemia) without any statistical conclusion of difference noted. Does not the lack of statistical evidence of difference make it impossible to support any conclusion of difference?
Of the subgroups prospectively identified by the CAPRIE trialists, the subgroup of patients with stroke and the subgroup with myocardial infarction showed no significant difference . . . [Full Text of this Article] AUTHOR INFORMATION
Donald B. Hansen, PharmD
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