Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Atherothrombotic Events

The Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial compared clopidogrel plus aspirin with aspirin alone for reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes in patients with stable cardiovascular disease or multiple cardiovascular risk factors. There was no difference between the treatment groups in this outcome. This trial compared clopidogrel plus aspirin with aspirin alone for reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes in patients with stable cardiovascular disease or multiple cardiovascular risk factors. There was no difference between the treatment groups in this outcome. Atherosclerotic vascular disease has a propensity to engender arterial thrombosis, a sequence that has been characterized as an “atherothrombotic” process. 1 , 2 Collectively, atherothrombotic disorders of the coronary, cerebrovascular, and peripheral arterial circulation are the leading cause of death and disability in the world. 3 Their prevalence is increasing; they are significantly undertreated, and better means of prevention are needed. 4 Platelets have been shown to play a central role in the pathogenesis of atherothrombosis. 1 , 2 Low-dose aspirin has been shown to reduce ischemic outcomes in patients above a certain risk threshold. 5 However, aspirin alone in many instances is not sufficient to prevent . . .