There is a common way to control coronary heart disease. Many patients of a certain age are currently advised to take low doses of aspirin at a time of certain age to prevent a re -heart attack or stroke.
The resulting evidence indicates that there is already a better choice.
Recently performed meta -analysis of the international team of cardiologists, it determines that clopidogrel, which stops platelets in the blood from adhesion, is a superior choice than aspirin in eventually patients with coronary artery disease.
Oral drugs work between groups of all ages, ethnic groups, gender and body sizes, and it is very effective in the “thinning” blood.
Related: Shocking number still does not know the risk of taking aspirin every day
Compared to aspirin, Clopidogrel reduces the risk of about 14 percent of the future heart attack, stroke or cardiovascular death, and most importantly, does not increase the risk of bleeding.
The drug has been checked only as secondary treatment, which means that it does not allow large cardiovascular disease of those who have already experienced a heart attack or stroke.
“These findings confirm the discussion of clopidogrel as a desired long-term antiplature strategy, instead of aspirin in patients with coronary artery disease,” the authors’ conclusion led by Ki Hong Choi from Sungkyunkwan University in South Korea and Marco Eating from the Cardiocentre
Clopidogrel (often sold under Plavix) is often used as short -term treatment after heart attacks or strokes. 2023 It was counted among the top 50 drugs, mostly prescribed in the US.
The American Heart Association (AHA) is currently advising that patients with peripheral artery disease – outside the heart or brain – use clopidogrel rather than daily aspirin because it is more effective to prevent major vascular phenomena.
However, while some recent studies show that coronary artery disease is useful, clopidogrel is usually recommended only if the patient is unable to take aspirin for any reason.
That advice data is outdated, some cardiologists say.
“[T]It is evidence to support the long-term use of aspirin monotherapy for decades, mainly based on small studies performed before modern pharmacotherapies and revascularization strategies, ”write to authors of the latest meta-analysis.
Researchers formed all the important random sample studies they could find, comparing clopidogrel with aspirin, choosing seven studies that, together with nearly 29,000 patients.
About half of the participants received clopidogrel as monotherapeutic treatment of coronary artery diseases and the other half aspirin.
After more than five years of observation, those who used clopidogrel were less likely than those who took aspirin to experience large negative cardiovascular or cerebral vascular events.
Even in individuals with East Asian ancestors, which are less affected by short -term clopidogrel treatment, there were better clopidogrel results compared to aspirin.
“As far as we know, Clopidogrel Monotherapy is the only treatment with anti-cladding towers, which has constantly showed greater effectiveness than aspirin without compromising security,” the team writes.
Choi, eating and their colleagues are not the only cardiologists who think there may be better options than aspirin.
2020 In a review article published in AHA Journal, CirculationCardiologists of Johns Hopkins University, Harvard University, Masachusetts General Hospital and Ireland National University have called for further research.
The role of aspirin in early treatment of a heart attack is well -established, admits the team, but when the day’s aspirin and cardiovascular disease tests, patients have not been conducted for very long and many did not use low doses of aspirin in patients.
Nevertheless, these are data on which today’s guidelines are mainly based. Patients who are concerned with current treatment courses are encouraged to discuss their capabilities with medical professionals before any changes.
It may be time to re -assess the risk and benefits of low doses of aspirin, especially among the older folk with a higher risk of bleeding. CLopidogrel waits in the wings.
The investigation has been published Lancett;