6/30/23, 12:47 AM WOEST Pathway Feedback Search Clinical Topics Home Studies WOEST WOEST Disease Disease Coronary artery disease Perioperative management of an Trial question What is the role of double therapy with clopidogrel in patients receiving OACs and undergoing PCI? Study design Multi-center Open label RCT Population Characteristics of study participants 20.4% female N = 573 79.6% male 573 patients (115 female, 448 male) Inclusion criteria: adults receiving OACs and undergoing PCI Key exclusion criteria: history of intracranial bleeding; cardiogenic shock; contraindication to use of aspirin, clopidogrel, or both; peptic ulcer in the previous 6 months; thrombocytopenia; major bleeding in the past 12 months; and pregnancy. Interventions N=279 double antithrombotic therapy (anticoagulation plus clopidogrel) N=284 triple antithrombotic therapy (anticoagulation plus aspirin and clopidogrel) Primary outcome Bleeding complications at 1 year 44.4 % 44.4 https://web.pathway.md/studies/recJWWs5aN7HDkqtp 1/2 6/30/23, 12:47 AM WOEST Pathway 33.3 % 22.2 % 19.4 Significant decrease 11.1 % NNT = 4 0.0 % Double antithrombotic therapy Triple antithrombotic therapy Significant decrease in bleeding complications at 1 year (19.4% vs. 44.4%; HR 0.36, 95% CI 0.26 to 0.5) Secondary outcomes Significant decrease in death, myocardial infarction, stroke, target-vessel revascularisation, or stent thrombosis (11.1% vs. 17.6%; HR 0.6, 95% CI 0.38 to 0.94) No significant difference in myocardial infarction (3.2% vs. 4.6%; HR 0.69, 95% CI 0.29 to 1.6) No significant difference in stroke (1.1% vs. 2.8%; HR 0.37, 95% CI 0.1 to 1.4) Conclusion In adults receiving OACs and undergoing PCI, double antithrombotic therapy was superior to triple antithrombotic therapy with respect to bleeding complications at 1 year. Reference Dewilde WJ, Oirbans T, Verheugt FW et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open- label, randomised, controlled trial. Lancet. 2013 Mar 30;381(9872):1107-15. Open reference URL https://web.pathway.md/studies/recJWWs5aN7HDkqtp 2/2