Combining clopidogrel and aspirin in coronary artery disease

This study investigated if clopidogrel (Plavix) and aspirin are effective when taken together for treating coronary artery disease (CAD). They found that clopidogrel and aspirin improved CAD symptoms compared to aspirin alone.

Coronary artery disease (CAD) is caused by reduced blood flow to the heart. This leads to reduced oxygen (ischemia). CAD can lead to myocardial infarction (MI), also known as a heart attack. The damage caused by a heart attack cannot be reversed. One serious event resulting from CAD is ST-segment elevation MI or STEMI. This is a heart attack that is identified by a change in the ST segment of the heart wave pattern. Following STEMI, patients undergo a procedure to restore blood flow to the heart. This is called percutaneous coronary intervention (PCI). PCI improves blood flow but it does not resolve STEMI.

Patients with STEMI have an increased risk of having a second heart attack. Medication such as aspirin can help manage STEMI. Aspirin reduces inflammation and prevents the blood from becoming too thick. Another drug to treat STEMI is clopidogrel. It stops blood cells called platelets from clumping and blocking blood flow. Some studies suggest combining clopidogrel and aspirin to treat STEMI patients. It is unclear if combined treatment is more effective than aspirin alone. 

This study included 136 patients with STEMI. Patients were randomly assigned to receive aspirin (68) or aspirin plus clopidogrel (68; combined treatment) treatment. Patients were treated with other medications as recommended by their doctors. The daily dose of aspirin was 100 mg and clopidogrel was 75 mg. Patients were treated for 4 weeks.

Patients taking combined treatment had reduced signs of heart damage compared to aspirin-treated patients. Heart and kidney function was improved in both groups, with a greater improvement seen in patients treated with the combination. The levels of proteins and chemicals involved in inflammation were reduced in both groups. The combined treatment group a greater reduction in these chemicals.

The authors concluded that clopidogrel and aspirin combined improved CAD symptoms in patients with STEMI.

This was a short study lasting 4 weeks. Larger, long-term studies are needed to determine the safety and effectiveness of this combination.

If you have any concerns regarding CAD treatment, please consult with your physician.