Date post: | 14-Dec-2014 |
Category: |
Health & Medicine |
Upload: | heartmeds |
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The Case for Clopidogrel Only
Focus
• Comfort• Cost• Side Effects
Comfort – CURE
NEJM 2001;345: 494-502.
12,562 pts with NSTE-ACS
Comfort – PCI CURE
Lancet 2001; 358: 527–33.
Comfort - COMMIT
Lancet 2005; 366: 1607–21.
45,852 acute MI patients87% were STEMI
Comfort – Comparison
Cost – Clopidogrel
30 days 90 days 1 year
Clopidogrel $13.87 $22.82 $111.43
Prasugrel $211.83 $627.85 $2546.28
Ticagrelor $255.76 $756.79 $3053.18
GoodRx.com; Accessed 9/12/2012
Relative Cost
Relative Cost
Bleeding - CURE12,562 pts with NSTE-ACS
Fatal Bleeding Comparison
NEJM 2007;357:2001-15.
TRITON
Bleeding Comparison
NEJM 2009;361:1045-57.
Non-CABG related Bleeding, study definedPLATO
Dyspnea
NEJM 2009;361:1045-57.
PLATO
Ventricular Pauses
NEJM 2009;361:1045-57.
PLATO
Conclusions
• Clopidogrel is easy and comfortable to use• Clopidogrel is extremely less expensive
compared to the newer agents• Clopidogrel doesn’t increase fatal bleeding,
dyspnea, or ventricular pauses