What is the effect of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation?
Clopidogrel in addition to aspirin is shown to improve outcomes in patients with acute coronary syndromes without ST-segment elevation. Studies such as the Early and Sustained Dual Oral Antiplatelet Therapy (ESDOAT) trial and the Platelet Reactivity and Cardiovascular Outcomes After Percutaneous Coronary Intervention (GRAVITAS) trial have demonstrated that the combination of clopidogrel and aspirin reduces the risk of major cardiovascular events, such as heart attack and stroke. Additionally, a meta-analysis of randomized trials found that clopidogrel provides an incremental benefit in reducing the risk of important cardiovascular events compared to aspirin alone. Furthermore, studies have demonstrated that genetic factors, such as cytochrome P450 2C19 genotype, can affect the antiplatelet effect and clinical efficacy of clopidogrel therapy.  