TDNet Discover

Background: Cardiovascular disease (CVD) along with ischemic events are the number one killer in the United States as well as worldwide. Aspirin is an antiplatelet agent that is used by many as a first line option for the management of CVD, as well as the treatment for ischemic events. Newer antiplatelet agents, clopidogrel in this case, have begun to be used for situations such as post-operative management, but have not broken through to become used as initial preventative agents. Objective: To determine the effectiveness of aspirin plus clopidogrel versus aspirin alone in the management of risk in CVD and ischemic events. Methods: An evidence-based medicine literature review was performed to search for studies in three databases to address the research question. Terms and phrases used to search for these studies were: “Aspirin”, “Aspirin AND Clopidogrel”, “Aspirin AND Clopidogrel AND Ischemic”, “Aspirin AND Clopidogrel AND CVD”. The limits for this search included studies within the last 10 years, peer-reviewed articles, full text available, and humans only. The initial search produced 22 possible studies which were then narrowed down based on exclusion and inclusion criteria. Results: After review of the article abstracts, three articles were used for this evidence-based medicine literature review. Johnston et al. was a randomized trial demonstrating combination therapy having more risk reduction. Huang et al., a systematic review, demonstrated more risk reduction with combination therapy. Squizzato et al., also a systematic review, demonstrated moderate evidence of better risk reduction with combination therapy. Conclusions: The three studies analyzed as a body of evidence supports there is a risk reduction with combination antiplatelet therapy. The analysis demonstrated the need for additional randomized control trials that use consistent variables between the trials