Extra-cardiac vascular disease and effectiveness of sustained clopidogrel therapy

Debabrata Mukherjee ^1*, Eric J Topol ², David J Moliterno ¹, Danielle M Brennan ², Khaled Ziada ¹, Leslie Cho ³ and Steven R Steinhubl ¹

¹ University of Kentucky, United States
² Cleveland Clinic Foundation, United States
³ Loyola University, United States

^* To whom correspondence should be addressed. E-mail: mukherjee{at}uky.edu.

Accepted 20 April 2005

Abstract

Objective: To assess the effectiveness of long-term clopidogrel therapy in patients with extra-cardiac vascular disease [ECVD] (i.e. history of either peripheral arterial disease or cerebrovascular disease).

Design: Subgroup analysis of a prospective randomised clinical trial.

Setting: The Clopidogrel for the Reduction of Events During Observation (CREDO) trial was a randomised, double-blind, placebo-controlled trial conducted at 99 centres in North America from June 1999 to April 2001.

Patients: 2116 patients who were to undergo elective coronary intervention or were deemed at high likelihood of undergoing PCI were enrolled in the CREDO trial. The current study sample consisted of 272 patients with ECVD.

Main outcome measure: One-year incidence of the composite of death, myocardial infarction (MI), or stroke in the intent-to-treat population.

Results: Patients with ECVD had a > 2-fold greater relative risk reduction with clopidogrel for the primary endpoint compared with patients without ECVD (47.9%, 95% CI -4.2% to 73.9%, and 18.2 %, 95% CI -10.5 % to 39.5 %, respectively).

Conclusions: Longer term clopidogrel therapy provides added protection against thrombotic events throughout the arterial vasculature, not limited to the coronary arteries and may be especially effective for patients with more diffuse atherosclerosis such as ECVD.

Keywords: antiplatelt therapy, clopdogrel, peripheral arterial disease, vascular disease

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Antiplatelet therapy and the vascular tree

A Blann
Heart 2006 92: 3-4. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Hackam, D G, Sultan, N M, Criqui, M H (2009). Vascular protection in peripheral artery disease: systematic review and modelling study. Heart 95: 1098-1102 [Abstract] [Full Text]  
• Hackam, D. G, Eikelboom, J. W (2007). Antithrombotic treatment for peripheral arterial disease. Heart 93: 303-308 [Abstract] [Full Text]  
• Blann, A (2006). Antiplatelet therapy and the vascular tree. Heart 92: 3-4 [Full Text]