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The (Variable) Definition of Benefit in the Case of Clopidogrel vs Aspirin—Reply
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In reply
We do not agree with Hansen. The CAPRIE subgroup analyses that we presented in our article did demonstrate a statistically significant reduction in ischemic events with clopidogrel vs aspirin, as was also seen in the overall CAPRIE analysis, though of a different magnitude.1-6 Furthermore, bleeding rates and rehospitalization for bleeding were lower, not higher, with clopidogrel than with aspirin.2, 6 In fact, the whole point of the article was that high-risk subgroups appear to derive a larger degree of benefit from more potent antiplatelet therapy.
In real-world practice, physicians need to make decisions on their patients based on whatever data are available at the time. The data are always open to some degree of interpretation, and sometimes data from different trials may even appear to produce conflicting results. This is part of the practice of medicine and something physicians must struggle with every day.
Furthermore, various interpretations of data . . . [Full Text of this Article]
AUTHOR INFORMATION
Deepak L. Bhatt, MD, FACC, FSCAI, FESC;
Jack Hirsh, CM, MD, FRCPC, FRACP, FRSC, DSc
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The (Variable) Definition of Benefit in the Case of Clopidogrel vs Aspirin
Donald B. Hansen
Arch Intern Med. 2005;165(11):1310.
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Comparative Benefits of Clopidogrel and Aspirin in High-Risk Patient Populations: Lessons From the CAPRIE and CURE Studies
Jack Hirsh and Deepak L. Bhatt
Arch Intern Med. 2004;164(19):2106-2110.
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