Aspirin better than clopidogrel on major adverse cardiovascular events reduction after ischemic stroke: A retrospective nationwide cohort study

Amelia Nur Vidyanti, Lung Chan, Cheng-Li Lin, Chih-Hsin Muo, Chung Y Hsu, You-Chia Chen, Dean Wu and Chaur-Jong Hu

PLOS ONE, 2019, vol. 14, issue 8, 1-10

Abstract: Background: Several clinical trials reported that clopidogrel was superior to aspirin in secondary stroke prevention by reducing the risk of major adverse cardiovascular events (MACE). We aimed to compare the efficacy of clopidogrel with aspirin in reducing one-year risk of MACE based on real-world evidence from Taiwan Health Insurance Database. Methods: We identified ischemic stroke patients between 2000 and 2012 who took aspirin or clopidogrel within 7 days of stroke onset for 1-year follow-up. The primary outcome was one-year MACE including recurrent stroke, acute myocardial infarction, and death. Propensity score matching and conditional Cox proportional hazards regression were conducted to control the confounding factors. Results: From 9,089 ischemic stroke patients, we found 654 patients on aspirin and 465 patients on clopidogrel who met the selective inclusion criteria. After propensity score matching, 379 patients were selected from each group. The clopidogrel group had a 1.78-fold MACE risk compared with the aspirin group at one-year follow-up (95% CI = 1.41–2.26, p

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0221750

DOI: 10.1371/journal.pone.0221750

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