6/28/23, 12:24 AM CURE Pathway Feedback Search Clinical Topics Home Studies CURE CURE Disease Non-ST-elevation myocardial inf Trial question What is the role of clopidogrel in patients with acute coronary syndromes without ST-segment elevation receiving aspirin? Study design Multi-center Double blinded RCT Population Characteristics of study participants 38.0% female N = 12562 62.0% male 12562 patients (4836 female, 7726 male) Inclusion criteria: patients with acute coronary syndromes without ST-segment elevation receiving aspirin Key exclusion criteria: contraindications to antithrombotic or antiplatelet therapy, high risk for bleeding or severe HF, receipt of OACs, and coronary revascularization in the previous 3 months Interventions N=6259 clopidogrel (300 mg immediately, followed by 75 mg once daily) N=6303 placebo (matching placebo daily) Primary outcome Death from cardiovascular causes, nonfatal MI, or stroke 11.4 % 11.4 https://web.pathway.md/studies/recsg6ycpT06ZqaJG 1/2 6/28/23, 12:24 AM CURE Pathway 9.3 8.6 % 5.7 % Significant decrease 2.9 % NNT = 48 0.0 % Clopidogrel Placebo Significant decrease in death from cardiovascular causes, nonfatal MI, or stroke (9.3% vs. 11.4%; RR 0.8, 95% CI 0.72 to 0.9) Secondary outcomes Significant decrease in refractory ischemia, death from cardiovascular causes, nonfatal MI, or stroke (16.5% vs. 18.8%; RR 0.86, 95% CI 0.79 to 0.94) Significant increase in major bleeding (3.7% vs. 2.7%; RR 1.38, 95% CI 1.13 to 1.67) Safety outcomes No significant differences in life-threatening bleeding (2.2% vs. 1.8%, p=0.13) or hemorrhagic stroke (0.1% vs. 0.1%). Significant differences in major bleeding (3.7% vs. 2.7%, p = 0.001; RR 1.38). Conclusion In patients with acute coronary syndromes without ST-segment elevation receiving aspirin, clopidogrel was superior to placebo with respect to death from cardiovascular causes, nonfatal MI, or stroke. Reference Yusuf S, Zhao F, Mehta SR et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001 Aug 16;345(7):494-502. Open reference URL https://web.pathway.md/studies/recsg6ycpT06ZqaJG 2/2