Thienopyridine derivatives versus aspirin for preventing stroke and other serious vascular events in high vascular risk patients.

@article{Sudlow2009ThienopyridineDV,
  title={Thienopyridine derivatives versus aspirin for preventing stroke and other serious vascular events in high vascular risk patients.},
  author={Cathie L. M. Sudlow and Gillian Mason and James B Maurice and Catherine J. Wedderburn and Graeme J. Hankey},
  journal={The Cochrane database of systematic reviews},
  year={2009},
  volume={4},
  pages={
          CD001246
        }
}
BACKGROUND Aspirin is the most widely studied and prescribed antiplatelet agent for preventing serious vascular events, reducing the odds of such events among high vascular risk patients by about a quarter. Thienopyridine derivatives inhibit platelet activation by a different mechanism and so may be more effective. OBJECTIVES To determine the effectiveness and safety of thienopyridine derivatives (ticlopidine and clopidogrel) versus aspirin for preventing serious vascular events (stroke… 
Thienopyridine Derivatives Versus Aspirin for Preventing Stroke and Other Serious Vascular Events in High Vascular Risk Patients
TLDR
Thienopyridine derivatives, including clopidogrel and ticlopidine, inhibit platelet activation by a different mechanism and so may be more effective than aspirin for preventing serious vascular events in patients at high risk.
Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.
TLDR
The benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or were at high risk of atherothrombotic disease, but did not have a coronary stent are reviewed.
Multiple versus one or more antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack
TLDR
To determine the effectiveness and safety of initiating, within 72 hours after an ischaemic stroke or TIA, multiple anti platelet agents versus fewer antiplatelet agents to prevent stroke recurrence, the analysis explores the evidence for different drug combinations.
Antiplatelet agents for intermittent claudication.
TLDR
Antiplatelet agents have a beneficial effect in reducing all cause mortality and fatal cardiovascular events in patients with IC and there is an urgent need for multicentre trials to compare the effects of aspirin against thienopyridine.
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TLDR
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TLDR
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TLDR
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Antiplatelets in stroke prevention.
TLDR
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Adenosine-diphosphate (ADP) receptor antagonists for the prevention of cardiovascular disease in type 2 diabetes mellitus.
TLDR
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Antiplatelets in secondary stroke prevention: should clopidogrel be the first choice?
TLDR
It is likely that clopidogrel is effective because transient ischaemic attacks and stroke are part of the same disease spectrum, and could thus be useful as first line secondary prevention therapy in all non-cardioembolic stroke subtypes and transient isCHAemic attacks, to prevent recurrent ischaemia events in all vascular territories.
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References

SHOWING 1-10 OF 60 REFERENCES
Thienopyridine Derivatives Versus Aspirin for Preventing Stroke and Other Serious Vascular Events in High Vascular Risk Patients
TLDR
Thienopyridine derivatives, including clopidogrel and ticlopidine, inhibit platelet activation by a different mechanism and so may be more effective than aspirin for preventing serious vascular events in patients at high risk.
Thienopyridine derivatives (ticlopidine, clopidogrel) versus aspirin for preventing stroke and other serious vascular events in high vascular risk patients.
TLDR
Thienopyridine derivatives are modestly but significantly more effective than aspirin in preventing serious vascular events in patients at high risk and specifically in patients with a previous TIA or ischaemic stroke.
Thienopyridines or aspirin to prevent stroke and other serious vascular events in patients at high risk of vascular disease? A systematic review of the evidence from randomized trials.
TLDR
The thienopyridines appear modestly more effective than aspirin in preventing serious vascular events in high-risk patients and clopidogrel appears to be safer than ticlopidine and as safe as aspirin, making it an appropriate, but more expensive, alternative antiplatelet drug for patients unable to tolerate aspirin.
A randomised, blinded, trial of Clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE)
TLDR
Long-term administration of clopidogrel to patients with atherosclerotic vascular disease is more effective than aspirin in reducing the combined risk of ischaemic stroke, myocardial infarction, or vascular death.
Ticlopidine. An updated review of its pharmacology and therapeutic use in platelet-dependent disorders.
TLDR
Ticlopidine reduces the incidence of further stroke, myocardial infarction or vascular death, and is superior to placebo and aspirin in studies of patients with recent stroke or transient ischaemic attacks, or intermittent claudication and has a promising role in other disorders mediated by platelet dysfunction.
Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke.
TLDR
The trial did not meet the predefined criteria for noninferiority but showed similar rates of recurrent stroke with ASA-ERDP and with clopidogrel, and there is no evidence that either of the two treatments was superior to the other in the prevention of recurrent strokes.
Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events.
TLDR
Overall, clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes.
Aspirin and ticlopidine for prevention of recurrent stroke in black patients: a randomized trial.
TLDR
Aspirin is regarded as a better treatment for aspirin-tolerant black patients with noncardioembolic ischemic stroke and the risk of serious adverse events with ticlopidine is thought to be low.
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