A study has recommended against any changes to current use of clopidogrel in patients with acute coronary syndrome treated medically or with percutaneous coronary intervention.
The NHS Regional Drug and Therapeutics Centre in Newcastle, UK, produced a rapid appraisal of a retrospective observational study, published in the Journal of the American Medical Association, which investigated whether risk of death or acute myocardial infarction (MI) was greater in the 90-day period after cessation of clopidogrel therapy compared with the period beyond 90 days in patients having had a recent MI.
The appraisal concluded: “The risk of death or MI is approximately doubled in the first 90 days following clopidogrel cessation compared to the 90-day period following that for patients medically treated for a mean of 302 days, or 278 days for patients treated with percutaneous coronary intervention.
“However, this risk has not been proven with longer duration of clopidogrel treatment, as is the case in UK practice.
“The results of this study are interesting but do not warrant any changes to current practice in the use of clopidogrel in patients with acute coronary syndrome (ACS) treated either medically or with percutaneous coronary intervention.”