Introduction
Clopidogrel Monotherapy versus Aspirin Monotherapy in Patients with Established Cardiovascular Disease: Systematic Review and Meta-Analysis
Introduction: Although aspirin (ASA) is the mainstay of treatment for the prevention of recurrent ischemic stroke, the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) trial showed ASA monotherapy to be inferior to clopidogrel in preventing recurrent adverse cardiovascular outcomes in patients with high cardiac risks
The most frequently used regimen for patients treated with DAPT for ≤30 days or >30 days was aspirin plus clopidogrel versus aspirin monotherapy
Clopidogrel monotherapy, compared with aspirin monotherapy during the chronic maintenance period after percutaneous coronary intervention with DES significantly reduced the risk of the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and BARC bleeding type 3 or greater
This trial compared aspirin monotherapy to aspirin plus ticagrelor, rather than clopidogrel
The C-MODE trial (Clopidogrel Versus Aspirin Monotherapy After 1- to 3-Month of Dual-Antiplatelet Therapy Following Zotarolimus-Eluting Onyx Stents Implantation; NCT05320926) is randomizing ≈3700 patients with PCI on dual antiplatelet therapy for 1 to 3 months to clopidogrel or aspirin
This finding is in accord with a recent meta-analysis showing that using aspirin monotherapy (hazard ratio [HR]: The rates of both ischemic and bleeding events were each significantly reduced with clopidogrel monotherapy versus aspirin monotherapy
aspirin monotherapy on vascular function and hemostatic measurement
Furthermore, the newer P2Y 12 inhibitors ticagrelor and prasugrel are more potent and consistent in effect than clopidogrel [ 44 ]
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Objectives: This study compared clopidogrel monotherapy following 1 month of DAPT (clopidogrel group) with aspirin monotherapy following 12 months of DAPT (aspirin group) after PCI for 5 years