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CURRENT-OASIS-7 TRIAL |
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|---|---|
| Problem | ACS |
| Format | Double-blinded multi-center RCT |
| Treatment | Low/high dose clopidogrel & aspirin |
| Control | - |
| Population | 25086 patients |
| Inclusion criteria | 18 years of age or older Non ST-segment elevation OR ST-segment elevation myocardial infarction Either -electrocardiographic changes compatible with ischemia -elevated levels of cardiac biomarkers An additional requirement was coronary angiographic assessment, with a plan to perform PCI as early as possible but no later than 72 hours after randomisation. |
| Exclusion criteria | Increased risk of bleeding or active bleeding and a known allergy to clopidogrel or aspirin |
| Follow-up | 30 days |
| Primary endpoint | Cardiovascular death, myocardial infarction, or stroke at 30 days |
| Secondary endpoint(s) | Composite of death from cardiovascular causes, myocardial infarction, stroke, or recurrent ischemia; the individual components of the primary outcome; and death from any cause |
| Details | . |
| Brief summary: | 600mg clopidogrel superior in PCI patients only; No benefits of 300mg aspirin over 75mg after loading |
| PAPER: Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. | |
|---|---|
| Date | 2 Sep 2010 |
| Journal | N Engl J Med. 2010 Sep 2;363(10):930-42. |
| Information | ALL patients: -600mg (loading) & 150mg vs. 300mg (loading) & 75mg Clopidogrel --No significant difference in primary outcome of cardiovascular death, MI or stroke --Increased risk of major bleeding --No significant difference in intracranial, CABG-related or fatal bleeding. -300mg (laoding) & 75-100mg vs. 300mg (loading) & 300-325mg Aspirin --No significant difference in primary outcome of cardiovascular death, MI or stroke --No significant difference in bleeding |
| PAPER: Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7) | |
|---|---|
| Date | 9 Oct 2010 |
| Journal | Lancet. 2010 Oct 9;376(9748):1233-43. |
| Information | Prespecified analysis is of the 17,263 individuals who underwent PCI -600mg (loading) & 150mg vs. 300mg (loading) & 75mg Clopidogrel --Significant reduction in primary outcome of cardiovascular death, MI or stroke --Significant reduction in stent thrombosis --Increased risk of major bleeding --No increase in intracranial/fatal bleeding -300mg (laoding) & 75-100mg vs. 300mg (loading) & 300-325mg Aspirin --No significant difference in primary outcome of cardiovascular death, MI or stroke --No difference in bleeding |