See also:
All cardiovascular prevention clinical trials
All clinical trials of antiplatelets drug
All clinical trials of clopidogrel + aspirin
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Treatments
Studied treatment |
clopidogrel (75 mg per day) plus low-dose aspirin (75 to 162 mg per day)
|
Control treatment |
placebo plus low-dose aspirin
|
Patients
Patients |
patients with either clinically evident cardiovascular disease or multiple risk factors |
Inclusion criteria |
multiple atherothrombotic risk factors, documented coronary disease, documented cerebrovascular disease, or documented symptomatic peripheral arterial disease.
To meet the criterion for enrollment on the basis of multiple risk factors, patients were required to have two
major or three minor or one major and two minor risk factors. Major RF were Type 1 or 2 diabetes (with drug therapy); Diabetic nephropathy; Ankle/brachial index <0.9; Asymptomatic carotid stenosis >70% of luminal diameter; one or more carotid plaque, as evidenced by intima media thickness. Minor RF were Systolic blood pressure >150 mm Hg, despite therapy for at least 3 mo; Primary hypercholesterolemia; Current smoking >15 cigarettes/day; Male sex and age >65 yr or female sex and age >70 yr |
Exclusion criteria |
age<45y; oral antithrombotic medications or
nonsteroidal antiinflammatory drugs on a longterm
basis (although cyclooxygenase-2 inhibitors
were permitted); established
indications for clopidogrel therapy (such
as a recent acute coronary syndrome) |
Baseline characteristics |
Age (yr) |
median 64 (39-95) |
Female (%) |
29.75 |
Documented vascular disease |
77.9 |
Multiple risk factors |
21.05 |
Prior myocardial infarction |
34.55 |
Prior stroke |
24.6 |
Diabetes |
42 |
Peripheral arterial disease |
22.65 |
Diabetic nephropathy |
12.9 |
Hypertension |
73.95 |
Hypercholesterolemia |
73.95 |
|
Method and design
Randomized effectives |
7802 / 7801 (studied vs. control) |
Design |
Parallel groups |
Blinding |
Double blind |
Follow-up duration |
median 28 months |
Lost to follow-up |
0.45% |
Number of centre |
768 |
Geographic area |
32 countries |
Hypothesis |
Superiority |
Primary endpoint |
myocardial infarction, stroke or death from cardiovasculare causes |
Withdrawals (T1/T0) |
0.3% / 0.3% |
Results
Endpoint
Studied treat. n/N
Control treat. n/N
Graph
RR [95% CI]
All cause death
371 / 7802
374 / 7801
0,99 [0,86;1,14]
Non fatal MI
147 / 7802
159 / 7801
0,92 [0,74;1,15]
Major bleeding
130 / 7802
104 / 7801
1,25 [0,97;1,61]
cardiovascular event (fatal and non fatal)
534 / 7802
573 / 7801
0,93 [0,83;1,04]
Cardiovascular death
238 / 7802
229 / 7801
1,04 [0,87;1,24]
Non fatal stroke
149 / 7802
185 / 7801
0,81 [0,65;1,00]
Fatal bleeding
26 / 7802
17 / 7801
classic
1,53 [0,83;2,82]
0
2
1.0
Relative risks
|
Endpoint |
Events (%) |
Relative Risk |
95% CI |
Endpoint definition in the trial |
Ref |
Studied treat. |
Control treat. |
All cause death
|
371 / 7802 (4,8%) |
374 / 7801 (4,8%) |
0,99 |
[0,86;1,14] |
|
|
Non fatal MI
|
147 / 7802 (1,9%) |
159 / 7801 (2,0%) |
0,92 |
[0,74;1,15] |
|
|
Major bleeding
|
130 / 7802 (1,7%) |
104 / 7801 (1,3%) |
1,25 |
[0,97;1,61] |
|
|
cardiovascular event (fatal and non fatal)
|
534 / 7802 (6,8%) |
573 / 7801 (7,3%) |
0,93 |
[0,83;1,04] |
|
|
Cardiovascular death
|
238 / 7802 (3,1%) |
229 / 7801 (2,9%) |
1,04 |
[0,87;1,24] |
|
|
Non fatal stroke
|
149 / 7802 (1,9%) |
185 / 7801 (2,4%) |
0,81 |
[0,65;1,00] |
|
|
Fatal bleeding
|
26 / 7802 (0,3%) |
17 / 7801 (0,2%) |
1,53 |
[0,83;2,82] |
|
|
The primary endpoint (if exists) appears in blod characters
|
Reference(s) used for data extraction:
|
Endpoint |
studied treat. |
control treat. |
mean diff |
Absolute risk reduction
|
Endpoint |
Events rate |
Absolute risk reduction (ARR) |
Studied treat. |
Control treat. |
All cause death |
4,76% |
4,79% |
-0,4‰
|
Non fatal MI |
1,88% |
2,04% |
-1,5‰
|
Major bleeding |
1,67% |
1,33% |
3,3‰
|
cardiovascular event (fatal and non fatal) |
6,84% |
7,35% |
-5,0‰
|
Cardiovascular death |
3,05% |
2,94% |
1,1‰
|
Non fatal stroke |
1,91% |
2,37% |
-4,6‰
|
Fatal bleeding |
3,33‰ |
2,18‰ |
1,2‰
|
Reference(s)
Trials register # |
NA
|
Study web site link |
2 |
-
.
A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee..
Lancet 1996 Nov 16;348:1329-39
Pubmed
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Hubmed
| Fulltext
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