Cardiology>>>>>Ischaemic heart disease
Question 112#

A 60-year-old man with a history of PCI 3 years previously asks for your advice with respect to his pharmacologic treatment. He is asymptomatic and his CV risk factors include smoking, hypertension, hypercholesterolemia, and impaired glucose tolerance. His medications include aspirin, atorvastatin, metoprolol, metformin, and lisinopril. His friend told him that clopidogrel should be added to his regimen.

What is the correct statement about that suggestion in this particular patient?

A. There is no significant benefit associated with clopidogrel plus aspirin as compared with placebo plus aspirin in reducing the incidence of the primary endpoint of MI, stroke, or death from CV causes
B. There is a significant benefit associated with clopidogrel plus aspirin as compared with placebo plus aspirin in reducing the incidence of the primary endpoint of MI, stroke, or death from CV causes
C. The rate of severe or moderate bleeding is not significantly greater with clopidogrel and aspirin compared with aspirin alone
D. The rate of severe or moderate bleeding is significantly greater with clopidogrel and aspirin compared with aspirin alone
E. Answers a and d are correct

Correct Answer is E

Comment:

Answers a and d are correct. In the CHARISMA trial of 15,603 patients with established stable atherothrombotic disease or at high risk for such disease, there was no significant benefit associated with clopidogrel plus aspirin as compared with placebo plus aspirin in reducing the incidence of the primary endpoint of MI, stroke, or death from CV causes. Clopidogrel was associated with a significant increase in the rate of moderate bleeding.