xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT06021990</url>
    </required_header>
    <id_info>
      <org_study_id>804/LRH/MTI</org_study_id>
      <nct_id>NCT06021990</nct_id>
    </id_info>
    <brief_title>Clopidogrel in Preventing Exacerbations in Severe COPD</brief_title>
    <acronym>CLOPEX</acronym>
    <official_title>Role of Clopidogrel in Preventing Exacerbations in Patients With Severe COPD: An Open-label Randomized Controlled Trial.</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Lady Reading Hospital, Pakistan</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
      <collaborator>
        <agency>Pakistan Chest Society, Pakistan</agency>
        <agency_class>Other</agency_class>
      </collaborator>
    </sponsors>
    <source>Lady Reading Hospital, Pakistan</source>
    <oversight_info>
      <has_dmc>Yes</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
      <is_us_export>No</is_us_export>
    </oversight_info>
    <brief_summary>
      <textblock>
        Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disorder&#xD;
        characterized by gradual and progressive airflow limitation. It has been hypothesized that&#xD;
        clopidogrel may have role in reducing the exacerbation of COPD by reducing thromboembolic&#xD;
        events. Several observational studies have found that taking clopidogrel reduces the&#xD;
        likelihood of COPD exacerbations in patients with the disease. The study being conducted will&#xD;
        be a randomized control trial, from March 2023 to March 2024 in department of pulmonology,&#xD;
        LRH. The aim of the study is to determine the role of clopidogrel in reducing the frequency&#xD;
        of exacerbation in COPD patients compared to controls. The sampling will be done by&#xD;
        non-probability consecutive sampling and the patients will be randomly allocated in study and&#xD;
        control groups. Both the groups will be followed at 3rd, 6th and 12th month of the treatment&#xD;
        and will be compared for the outcomes.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disorder&#xD;
        characterised by gradual and progressive airflow limitation. It is a huge worldwide health&#xD;
        issue as well as a major cause of morbidity and mortality1. Currently, it is the third&#xD;
        leading cause of death2. Exacerbations, or abrupt worsening of symptoms that necessitate&#xD;
        medical treatment, are common in people with severe COPD3. Exacerbations negatively influence&#xD;
        patients' quality of life and are linked to higher healthcare utilisation and mortality4.&#xD;
  &#xD;
        Clopidogrel is a widely used antiplatelet medication that works by inhibiting platelet&#xD;
        aggregation by blocking the P2Y12 receptor5. Clopidogrel's potential benefits in the&#xD;
        treatment of COPD have piqued the curiosity of researchers in recent years. According to the&#xD;
        hypothesis, Clopidogrel may lower the incidence of exacerbations by reducing thromboembolic&#xD;
        events, which are prevalent causes of exacerbations in COPD.&#xD;
  &#xD;
        Several observational studies have found that taking clopidogrel reduces the likelihood of&#xD;
        COPD exacerbations in patients with the disease6. A meta-analysis on reduction of all-cause&#xD;
        mortality in COPD patients concluded that mortality might significantly lower in COPD&#xD;
        patients receiving antiplatelet treatment7. However, because of confounding considerations,&#xD;
        the findings of these observational studies should be regarded with caution. To confirm the&#xD;
        potential benefits of clopidogrel in lowering COPD exacerbations, randomised controlled&#xD;
        studies (RCTs) are required. Only a few RCTs have been undertaken to date, with inconsistent&#xD;
        outcomes.&#xD;
  &#xD;
        The inconsistent findings of the RCTs show the need for additional studies to determine the&#xD;
        role of clopidogrel in reducing COPD exacerbations. To offer more firm information on the&#xD;
        possible benefits and dangers of clopidogrel in this patient population, larger,&#xD;
        well-designed RCTs are required. The RCTs should also consider clopidogrel's potential side&#xD;
        effects, such as bleeding, which may be especially concerning in COPD patients who are&#xD;
        frequently on numerous drugs and may have comorbidities such as cardiovascular disease.&#xD;
  &#xD;
        Finally, the role of clopidogrel in lowering exacerbations in patients with severe COPD&#xD;
        remains unknown. Observational studies suggest that clopidogrel may have some benefits, while&#xD;
        RCT results are mixed. More research is needed to determine clopidogrel's safety and efficacy&#xD;
        in this patient population.&#xD;
  &#xD;
        Results of the study if successful, will have two impacts. First, it will help reducing the&#xD;
        financial burden on our health care system. Second, it will improve the quality of life of&#xD;
        patients by less frequent hospital visits with lowered mortality.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">October 1, 2023</start_date>
    <completion_date type="Anticipated">December 31, 2024</completion_date>
    <primary_completion_date type="Anticipated">September 30, 2024</primary_completion_date>
    <phase>Phase 3</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <intervention_model_description>After assessing eligibility and consent patients will be randomly assigned to either the intervention arm or control arm. The control arm would be standard of care treatment according to GOLD guidelines and approved by the Pakistan Chest Society. The intervention arm will take Clopidogrel 75mg dail according the study prototcol</intervention_model_description>
      <primary_purpose>Treatment</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Number of acute exacerbations of COPD</measure>
      <time_frame>28 days</time_frame>
      <description>The rate of COPD exacerbations during a 12-month period, which is characterised as a worsening of symptoms for less than 14 days needing systemic corticosteroids and/or antibiotics as treatment or admission to hospital for the symptoms, will be the main outcome indicator.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>The number of hospitalisations for COPD-related exacerbations</measure>
      <time_frame>28 days</time_frame>
      <description>The number of hospitalisations required for acute exacerbation of COPD will be compared in both the intervention arm and control arm.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Change in forced expiratory volume in one second (FEV1)</measure>
      <time_frame>28 days</time_frame>
      <description>The changes in FEV1 measured with a spirometer during the follow up visits will be compared between the intervantion arm and the control arm till the completion of the study</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Death</measure>
      <time_frame>12 months</time_frame>
      <description>Mortality and survival will be compared between the intervention arm and the control arm till the completion of the study</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Quality of life as measured by the St. George's Respiratory Questionnaire (SGRQ)</measure>
      <time_frame>28 days</time_frame>
      <description>Quality of life as measured by the St. George's Respiratory Questionnaire (SGRQ) will be compared between the intervention arm and the control arm till the completion of the study</description>
    </secondary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">162</enrollment>
    <condition>COPD</condition>
    <condition>COPD Exacerbation Acute</condition>
    <arm_group>
      <arm_group_label>Clopidogrel group</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>The clopidogrel group will receive the intervention under study (clopidogrel 75mg once daily post-meal) for the study period along with the standard of care treatment as approved by the hospital based on national and international guidelines.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Standard of Care</arm_group_label>
      <arm_group_type>No Intervention</arm_group_type>
      <description>The standard of care will receive treatment as approved by the hospital based on national and international guidelines.</description>
    </arm_group>
    <intervention>
      <intervention_type>Drug</intervention_type>
      <intervention_name>Clopidogrel Bisulfate 75Mg Tab</intervention_name>
      <description>Severe COPD patients who meet eligibility criteria will be given Clopidogrel Bisulfate 75 mg Tablet daily, along with standard of care treatment till the completion of the study duration or any side effects that warrants stoppage of the drug</description>
      <arm_group_label>Clopidogrel group</arm_group_label>
      <other_name>clopidogrel</other_name>
      <other_name>Plavix</other_name>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Patients diagnosed with severe COPD (GOLD stage III or IV)&#xD;
  &#xD;
            -  Patients with a history of at least one exacerbation in the past year.&#xD;
  &#xD;
            -  Patients who are able to understand and provide informed consent.&#xD;
  &#xD;
            -  Patients willing and able to comply with the study protocol and attend follow-up&#xD;
               visits.&#xD;
  &#xD;
            -  Patients who are between the ages of 40 and 80 years.&#xD;
  &#xD;
            -  Either gender&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Patients who have previously experienced serious medical issues, like a recent heart&#xD;
               attack or stroke (within six months),&#xD;
  &#xD;
            -  Patients who are known to be hypersensitive to clopidogrel.&#xD;
  &#xD;
            -  People who have a history of gastrointestinal bleeding or any other health issue that&#xD;
               could make them more likely to bleed.&#xD;
  &#xD;
            -  Women who are pregnant or nursing.&#xD;
  &#xD;
            -  Patients who are being treated with additional antiplatelet or anticoagulant&#xD;
               medications.&#xD;
  &#xD;
            -  People who suffer from severe renal or liver illness.&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>40 Years</minimum_age>
      <maximum_age>80 Years</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Zafar Iqbal, MBBS, MCPS, FCPS, DHPE</last_name>
      <role>Study Chair</role>
      <affiliation>Lady Reading Hospital, Pakistan</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Muhammad Imran, MBBS, FCPS</last_name>
      <phone>+923339457550</phone>
      <email>drimransth@gmail.com</email>
    </overall_contact>
    <overall_contact_backup>
      <last_name>Fakhra Mushtaq, MBBS</last_name>
      <phone>+923459614046</phone>
      <email>fakhramushtaq2@gmail.com</email>
    </overall_contact_backup>
    <location>
      <facility>
        <name>Pulmonology Department, Lady Reading Hospital, Peshawar</name>
        <address>
          <city>Peshawar</city>
          <state>Khyber Pakhtunkhwa</state>
          <zip>25000</zip>
          <country>Pakistan</country>
        </address>
      </facility>
    </location>
    <location_countries>
      <country>Pakistan</country>
    </location_countries>
    <reference>
      <citation>Pahal P, Hashmi MF, Sharma S. Chronic Obstructive Pulmonary Disease Compensatory Measures. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK525962/</citation>
      <PMID>30247837</PMID>
    </reference>
    <reference>
      <citation>Murarescu ED, Mitrofan EC, Mihailovici MS. Chronic obstructive pulmonary disease in a new concept. Rom J Morphol Embryol. 2007;48(3):207-14.</citation>
      <PMID>17914487</PMID>
    </reference>
    <reference>
      <citation>Kim V, Aaron SD. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur Respir J. 2018 Nov 15;52(5):1801261. doi: 10.1183/13993003.01261-2018. Print 2018 Nov.</citation>
      <PMID>30237306</PMID>
    </reference>
    <reference>
      <citation>Beekman E, Mesters I, Hendriks EJ, Muris JW, Wesseling G, Evers SM, Asijee GM, Fastenau A, Hoffenkamp HN, Gosselink R, van Schayck OC, de Bie RA. Exacerbations in patients with chronic obstructive pulmonary disease receiving physical therapy: a cohort-nested randomised controlled trial. BMC Pulm Med. 2014 Apr 26;14:71. doi: 10.1186/1471-2466-14-71.</citation>
      <PMID>24767519</PMID>
    </reference>
    <reference>
      <citation>Damman P, Woudstra P, Kuijt WJ, de Winter RJ, James SK. P2Y12 platelet inhibition in clinical practice. J Thromb Thrombolysis. 2012 Feb;33(2):143-53. doi: 10.1007/s11239-011-0667-5.</citation>
      <PMID>22183178</PMID>
    </reference>
    <reference>
      <citation>Kunadian V, Chan D, Ali H, Wilkinson N, Howe N, McColl E, Thornton J, von Wilamowitz-Moellendorff A, Holstein EM, Burns G, Fisher A, Stocken D, De Soyza A; APPLE COPD-ICON2 Trial Investigators. Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: protocol of a randomised controlled proof-of-concept trial (APPLE COPD-ICON 2). BMJ Open. 2018 May 26;8(5):e020713. doi: 10.1136/bmjopen-2017-020713.</citation>
      <PMID>29804061</PMID>
    </reference>
    <reference>
      <citation>Pavasini R, Biscaglia S, d'Ascenzo F, Del Franco A, Contoli M, Zaraket F, Guerra F, Ferrari R, Campo G. Antiplatelet Treatment Reduces All-Cause Mortality in COPD Patients: A Systematic Review and Meta-Analysis. COPD. 2016 Aug;13(4):509-14. doi: 10.3109/15412555.2015.1099620. Epub 2015 Dec 17.</citation>
      <PMID>26678708</PMID>
    </reference>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>August 27, 2023</study_first_submitted>
    <study_first_submitted_qc>August 27, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">September 1, 2023</study_first_posted>
    <last_update_submitted>August 27, 2023</last_update_submitted>
    <last_update_submitted_qc>August 27, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">September 1, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Lady Reading Hospital, Pakistan</investigator_affiliation>
      <investigator_full_name>Muhammad Imran</investigator_full_name>
      <investigator_title>Assistant Professor</investigator_title>
    </responsible_party>
    <keyword>COPD</keyword>
    <keyword>Acute exacerbation</keyword>
    <keyword>Clopidogrel</keyword>
    <keyword>Randomised Clinical Trial</keyword>
    <keyword>prevention</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Pulmonary Disease, Chronic Obstructive</mesh_term>
    </condition_browse>
    <intervention_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Clopidogrel</mesh_term>
    </intervention_browse>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT06021990
  org study id: 804/LRH/MTI
  nct id: NCT06021990
  lead sponsor: 
  collaborator: 
  has dmc: Yes
  is fda regulated drug: No
  is fda regulated device: No
  is us export: No
  Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disorder
        characterized by gradual and progressive airflow limitation. It has been hypothesized that
        clopidogrel may have role in reducing the exacerbation of COPD by reducing thromboembolic
        events. Several observational studies have found that taking clopidogrel reduces the
        likelihood of COPD exacerbations in patients with the disease. The study being conducted will
        be a randomized control trial, from March 2023 to March 2024 in department of pulmonology,
        LRH. The aim of the study is to determine the role of clopidogrel in reducing the frequency
        of exacerbation in COPD patients compared to controls. The sampling will be done by
        non-probability consecutive sampling and the patients will be randomly allocated in study and
        control groups. Both the groups will be followed at 3rd, 6th and 12th month of the treatment
        and will be compared for the outcomes.
  Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disorder
        characterised by gradual and progressive airflow limitation. It is a huge worldwide health
        issue as well as a major cause of morbidity and mortality1. Currently, it is the third
        leading cause of death2. Exacerbations, or abrupt worsening of symptoms that necessitate
        medical treatment, are common in people with severe COPD3. Exacerbations negatively influence
        patients' quality of life and are linked to higher healthcare utilisation and mortality4.
  
        Clopidogrel is a widely used antiplatelet medication that works by inhibiting platelet
        aggregation by blocking the P2Y12 receptor5. Clopidogrel's potential benefits in the
        treatment of COPD have piqued the curiosity of researchers in recent years. According to the
        hypothesis, Clopidogrel may lower the incidence of exacerbations by reducing thromboembolic
        events, which are prevalent causes of exacerbations in COPD.
  
        Several observational studies have found that taking clopidogrel reduces the likelihood of
        COPD exacerbations in patients with the disease6. A meta-analysis on reduction of all-cause
        mortality in COPD patients concluded that mortality might significantly lower in COPD
        patients receiving antiplatelet treatment7. However, because of confounding considerations,
        the findings of these observational studies should be regarded with caution. To confirm the
        potential benefits of clopidogrel in lowering COPD exacerbations, randomised controlled
        studies (RCTs) are required. Only a few RCTs have been undertaken to date, with inconsistent
        outcomes.
  
        The inconsistent findings of the RCTs show the need for additional studies to determine the
        role of clopidogrel in reducing COPD exacerbations. To offer more firm information on the
        possible benefits and dangers of clopidogrel in this patient population, larger,
        well-designed RCTs are required. The RCTs should also consider clopidogrel's potential side
        effects, such as bleeding, which may be especially concerning in COPD patients who are
        frequently on numerous drugs and may have comorbidities such as cardiovascular disease.
  
        Finally, the role of clopidogrel in lowering exacerbations in patients with severe COPD
        remains unknown. Observational studies suggest that clopidogrel may have some benefits, while
        RCT results are mixed. More research is needed to determine clopidogrel's safety and efficacy
        in this patient population.
  
        Results of the study if successful, will have two impacts. First, it will help reducing the
        financial burden on our health care system. Second, it will improve the quality of life of
        patients by less frequent hospital visits with lowered mortality.
  allocation: Randomized
  intervention model: Parallel Assignment
  intervention model description: After assessing eligibility and consent patients will be randomly assigned to either the intervention arm or control arm. The control arm would be standard of care treatment according to GOLD guidelines and approved by the Pakistan Chest Society. The intervention arm will take Clopidogrel 75mg dail according the study prototcol
  primary purpose: Treatment
  masking: None (Open Label)
  measure: Number of acute exacerbations of COPD
  time frame: 28 days
  description: The rate of COPD exacerbations during a 12-month period, which is characterised as a worsening of symptoms for less than 14 days needing systemic corticosteroids and/or antibiotics as treatment or admission to hospital for the symptoms, will be the main outcome indicator.
  measure: The number of hospitalisations for COPD-related exacerbations
  time frame: 28 days
  description: The number of hospitalisations required for acute exacerbation of COPD will be compared in both the intervention arm and control arm.
  measure: Change in forced expiratory volume in one second (FEV1)
  time frame: 28 days
  description: The changes in FEV1 measured with a spirometer during the follow up visits will be compared between the intervantion arm and the control arm till the completion of the study
  measure: Death
  time frame: 12 months
  description: Mortality and survival will be compared between the intervention arm and the control arm till the completion of the study
  measure: Quality of life as measured by the St. George's Respiratory Questionnaire (SGRQ)
  time frame: 28 days
  description: Quality of life as measured by the St. George's Respiratory Questionnaire (SGRQ) will be compared between the intervention arm and the control arm till the completion of the study
  arm group label: Clopidogrel group
  arm group type: Experimental
  description: The clopidogrel group will receive the intervention under study (clopidogrel 75mg once daily post-meal) for the study period along with the standard of care treatment as approved by the hospital based on national and international guidelines.
  arm group label: Standard of Care
  arm group type: No Intervention
  description: The standard of care will receive treatment as approved by the hospital based on national and international guidelines.
  intervention type: Drug
  intervention name: Clopidogrel Bisulfate 75Mg Tab
  description: Severe COPD patients who meet eligibility criteria will be given Clopidogrel Bisulfate 75 mg Tablet daily, along with standard of care treatment till the completion of the study duration or any side effects that warrants stoppage of the drug
  arm group label: Clopidogrel group
  other name: clopidogrel
  other name: Plavix
  criteria: 
  gender: All
  minimum age: 40 Years
  maximum age: 80 Years
  healthy volunteers: No
  last name: Zafar Iqbal, MBBS, MCPS, FCPS, DHPE
  role: Study Chair
  affiliation: Lady Reading Hospital, Pakistan
  last name: Muhammad Imran, MBBS, FCPS
  phone: +923339457550
  email: drimransth@gmail.com
  last name: Fakhra Mushtaq, MBBS
  phone: +923459614046
  email: fakhramushtaq2@gmail.com
  facility: 
  country: Pakistan
  citation: Pahal P, Hashmi MF, Sharma S. Chronic Obstructive Pulmonary Disease Compensatory Measures. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK525962/
  PMID: 30247837
  citation: Murarescu ED, Mitrofan EC, Mihailovici MS. Chronic obstructive pulmonary disease in a new concept. Rom J Morphol Embryol. 2007;48(3):207-14.
  PMID: 17914487
  citation: Kim V, Aaron SD. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur Respir J. 2018 Nov 15;52(5):1801261. doi: 10.1183/13993003.01261-2018. Print 2018 Nov.
  PMID: 30237306
  citation: Beekman E, Mesters I, Hendriks EJ, Muris JW, Wesseling G, Evers SM, Asijee GM, Fastenau A, Hoffenkamp HN, Gosselink R, van Schayck OC, de Bie RA. Exacerbations in patients with chronic obstructive pulmonary disease receiving physical therapy: a cohort-nested randomised controlled trial. BMC Pulm Med. 2014 Apr 26;14:71. doi: 10.1186/1471-2466-14-71.
  PMID: 24767519
  citation: Damman P, Woudstra P, Kuijt WJ, de Winter RJ, James SK. P2Y12 platelet inhibition in clinical practice. J Thromb Thrombolysis. 2012 Feb;33(2):143-53. doi: 10.1007/s11239-011-0667-5.
  PMID: 22183178
  citation: Kunadian V, Chan D, Ali H, Wilkinson N, Howe N, McColl E, Thornton J, von Wilamowitz-Moellendorff A, Holstein EM, Burns G, Fisher A, Stocken D, De Soyza A; APPLE COPD-ICON2 Trial Investigators. Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: protocol of a randomised controlled proof-of-concept trial (APPLE COPD-ICON 2). BMJ Open. 2018 May 26;8(5):e020713. doi: 10.1136/bmjopen-2017-020713.
  PMID: 29804061
  citation: Pavasini R, Biscaglia S, d'Ascenzo F, Del Franco A, Contoli M, Zaraket F, Guerra F, Ferrari R, Campo G. Antiplatelet Treatment Reduces All-Cause Mortality in COPD Patients: A Systematic Review and Meta-Analysis. COPD. 2016 Aug;13(4):509-14. doi: 10.3109/15412555.2015.1099620. Epub 2015 Dec 17.
  PMID: 26678708
  responsible party type: Principal Investigator
  investigator affiliation: Lady Reading Hospital, Pakistan
  investigator full name: Muhammad Imran
  investigator title: Assistant Professor
  mesh term: Pulmonary Disease, Chronic Obstructive
  mesh term: Clopidogrel