6/28/23, 12:06 AM CHARISMA Pathway Feedback Search Clinical Topics Home Studies CHARISMA CHARISMA Disease Disease Disease Acute ischemic stroke Coronary artery disease Non-ST Trial question What is the effect of combination of clopidogrel and aspirin in patients with high-risk for atherothrombotic events? Study design Multi-center Double blinded RCT Population Characteristics of study participants 30.0% female N = 15603 70.0% male 15603 patients (4644 female, 10959 male) Inclusion criteria: patients with either clinically evident CVD or multiple risk factors for atherothrombotic events Key exclusion criteria: receipt of oral antithrombotic medications or nonsteroidal antiinflammatory drugs on a long-term basis, recent acute coronary syndrome, or requirement of clopidogrel after revascularization procedure Interventions N=7802 clopidogrel and aspirin (clopidogrel 75 mg/day and aspirin 75-162 mg/day) N=7801 aspirin (aspirin 75-162 mg/day plus matching placebo) Primary outcome Myocardial infarction, stroke, or death from cardiovascular causes 7.3 7 3 % 6 8 https://web.pathway.md/studies/rect4idwT0Gy2Nud6 1/2 6/28/23, 12:06 AM CHARISMA Pathway 7.3 % 6.8 5.5 % 3.6 % 1.8 % No significant difference 0.0 % Clopidogrel and aspirin Aspirin No significant difference in myocardial infarction, stroke, or death from cardiovascular causes (6.8% vs. 7.3%; RR 0.93, 95% CI 0.83 to 1.05) Secondary outcomes Significant decrease in hospitalizations for ischemic events (16.7% vs. 17.9%; RR 0.92, 95% CI 0.86 to 0.99) No significant difference in myocardial infarction, stroke, or death from cardiovascular causes, in patients with multiple risk factors (6.6% vs. 5.5%; RR 1.2, 95% CI 0.91 to 1.59) Safety outcomes Significant differences in severe bleeding (1.7% vs. 1.3%, p = 0.09; RR 1.25, 95% CI 0.97-1.61). Conclusion In patients with either clinically evident CVD or multiple risk factors for atherothrombotic events, clopidogrel and aspirin were not superior to aspirin with respect to myocardial infarction, stroke, or death from cardiovascular causes. Reference Bhatt DL, Fox KA, Hacke W et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006 Apr 20;354(16):1706-17. Open reference URL https://web.pathway.md/studies/rect4idwT0Gy2Nud6 2/2