A new study suggests blood thinner clopidogrel may offer superior protection against heart attacks and strokes compared to aspirin for patients with a specific form of heart disease.
Crucially, the research also found clopidogrel did not increase the risk of major bleeding, a serious and common side effect of blood thinners.
Aspirin, a widely used medicine, is currently recommended indefinitely in low doses for individuals with coronary artery disease (CAD) – a condition where fatty deposits build up in the coronary arteries. It helps prevent cardiovascular events by making blood less sticky.
Researchers compared aspirin's effectiveness against clopidogrel, an antiplatelet medicine designed to prevent platelets from sticking together and forming clots.
The findings indicate a potential shift in treatment strategies, suggesting clopidogrel as a more effective option without heightened haemorrhage risk.
For the study, published in The Lancet and presented at the European Society of Cardiology (ESC) Congress in Madrid, experts analysed seven clinical trials including 28,982 patients overall.
Of the total, some 14,507 were given clopidogrel, while 14,475 were given aspirin.
The analysis found those on clopidogrel had a 14 per cent lower risk of potentially life-threatening conditions such as heart attacks, strokes and even death.
Rates of major bleeding were also similar between the two groups.
Researchers said for patients with CAD, clopidogrel “offers superior protection against major cardiovascular and cerebrovascular events compared with aspirin, without an excess risk of bleeding”.
“These results support a preference for clopidogrel over aspirin for chronic antiplatelet monotherapy for patients with stable CAD,” they added.
“The widespread availability, generic formulation, and affordability of clopidogrel further supports its potential for extensive adoption in clinical practice.”
Reacting to the findings, Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, said: “Aspirin is a commonly prescribed drug to help prevent repeat heart attacks and strokes.
“This research suggests that clopidogrel, an alternative to aspirin, might be more effective at preventing recurrent heart attack or stroke. Importantly, these benefits come without a greater risk of major bleeding.
“These findings are likely to impact the medications doctors prescribe to their patients to reduce their risk of future heart problems.”
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