Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation

摘要: Background Vitamin K antagonists reduce the risk of stroke in patients with atrial fibrillation but are considered unsuitable many patients, who usually receive aspirin instead. We investigated hypothesis that addition clopidogrel to would vascular events fibrillation. Methods A total 7554 had an increased and for whom vitamin K–antagonist therapy was were randomly assigned (75 mg) or placebo, once daily, aspirin. The primary outcome composite stroke, myocardial infarction, non–central nervous system systemic embolism, death from causes. Results At a median 3.6 years follow-up, major occurred 832 receiving (6.8% per year) 924 placebo (7.6% (relative clopidogrel, 0.89; 95% confidence interval [CI], 0.81 0.98; P = 0.01). difference primarily due reduction rate clopidogrel. Stroke 296 (2.4% 408 (3.3% risk, 0.72; CI, 0.62 0.83; P<0.001). Myocardial infarction 90 (0.7% 115 (0.9% 0.78; 0.59 1.03; 0.08). Major bleeding 251 (2.0% 162 (1.3% 1.57; 1.29 1.92; Conclusions In unsuitable, reduced events, especially hemorrhage. (ClinicalTrials.gov number, NCT00249873.)