© 2003 by BMJ Publishing Group & British Cardiac Society
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Ischaemic heart disease

Most cardiologists presently prescribe 24 weeks of clopidogrel after placing coronary stents. In patients with acute coronary syndromes, the CURE study suggests benefit to nine months, although most of the benefit was achieved in the first three days. The CREDO study suggests that one year of therapy may be appropriate. At one year, long term clopidogrel treatment was associated with a 26.9% relative reduction in the combined risk of death, myocardial infarction (MI), or stroke (95% confidence interval (CI) 3.9% to 44.4%; p =0.02; absolute reduction 3%). Clopidogrel pretreatment did not significantly reduce the combined risk of death, MI, or urgent target vessel revascularisation at 28 days (reduction 18.5%, 95% CI -14.2% to 41.8%; p = 0.23). However, in a prespecified subgroup analysis, patients who received clopidogrel at least six hours before percutaneous coronary intervention (PCI) experienced a relative risk reduction of 38.6% (95% CI -1.6% to 62.9%; p =
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