Clopidogrel has a “superior” effect compared to aspirin and without the suspected side effects according to the new study
Groundbreaking research unveiled at the European Society of Cardiology congress in Madrid has suggested aspirin may not be the gold standard for preventing heart attacks in heart patients after all. Scientists believe Clopidogrel could be the superior alternative.
For decades, aspirin has been the go-to medication for those at heightened risk of cardiovascular events such as heart attacks. With daily low-dose anti-inflammatory tablets known to ward off these life-threatening incidents.
However, the study, published in the Lancet journal, discovered that clopidogrel was not only “superior” at preventing heart attacks and strokes compared to aspirin, but also came without the risk factors.
These revelations are now challenging established medical practice of prescribing aspirin for cardiac patients. Previously, medics worried that clopidogrel might trigger more bleeding complications, but the research showed identical results to those taking aspirin.
Even patients who didn’t respond favourably to clopidogrel due to genetic or clinical reasons still experienced greater benefits from the blood thinner than they did with aspirin. The study has the potential to influence clinical guidelines worldwide, meaning heart patients could soon find their prescriptions changing.
Researchers tracked nearly 29,000 patients suffering from coronary artery disease, a prevalent form of heart condition that ranks as a leading cause of death and disability globally. Arterial narrowing due to fatty material buildup can lead to pain, discomfort, or even a heart attack, necessitating lifelong treatment for patients to prevent heart attacks and strokes, typically with aspirin.
Clopidogrel is an antiplatelet medication used to prevent blood clots and is sometimes prescribed for patients who have had a coronary artery stent fitted, although it carries a risk of increased bleeding.
Scientists have discovered that clopidogrel has a comparable rate of major bleeding issues to aspirin but also offers a 14% lower risk of major adverse cardiovascular or cerebrovascular events, such as heart attacks, strokes, or cardiovascular death, compared to those on aspirin.
Both drugs are widely accessible, and researchers are advocating for a shift in treatment guidelines for individuals with coronary artery disease.
They stated in their Lancet study: “This comprehensive synthesis of available evidence indicates that, in patients with CAD, long-term clopidogrel monotherapy offers superior protection against major cardiovascular and cerebrovascular events compared with aspirin, without an excess risk of bleeding.
“The superior efficacy of clopidogrel v aspirin was consistent across multiple key subgroups, including individuals with clinical features predictive of poor clopidogrel responsiveness, supporting the generalisability of these findings to the broad spectrum of patients with CAD.
“These results support a preference for clopidogrel over aspirin for chronic antiplatelet monotherapy for patients with stable CAD. The widespread availability, generic formulation and affordability of clopidogrel further supports its potential for extensive adoption in clinical practice.”
Further research will be necessary to ensure the cost-effectiveness of prescribing clopidogrel instead of aspirin as well as broader population studies before the pill can become a treatment standard.