Efficacy and Safety of Clopidogrel Versus Aspirin Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.

Background: Coronary artery disease (CAD) is the leading cause of death worldwide. After percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is recommended to reduce thrombotic events. This meta-analysis assesses the effectiveness of clopidogrel compared to aspirin monotherapy...

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Publicado en:Clinical Medicine Insights: Cardiology Vol. 20; pp. 1 - 12
Autores principales: Cheema, Ameer Haider, Hassan Waseem, Muhammad, Abideen, Zain ul, Tahir, Muhammad Zubair, Saleem, Fahad, Nadeem, Amna, Tauseef, Urvah, Qasim, Tahreem, Aimen, Sania, Zahid, Muhammad Bilal, Thada, Pawan Kumar
Formato: meta analysis research systematic review Journal Article
Publicado: Sage Publications Inc. 1/18/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1/18/2026
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        atl: Efficacy and Safety of Clopidogrel Versus Aspirin Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.
      aug:
        au:
          Cheema, Ameer Haider
          Hassan Waseem, Muhammad
          Abideen, Zain ul
          Tahir, Muhammad Zubair
          Saleem, Fahad
          Nadeem, Amna
          Tauseef, Urvah
          Qasim, Tahreem
          Aimen, Sania
          Zahid, Muhammad Bilal
          Thada, Pawan Kumar
        affil: University of Texas Southwestern, Dallas, TX, USA
      sug:
        subj:
          Drug Efficacy
          Coronary Arteriosclerosis
          Patient Safety
          Aspirin
          Clopidogrel Bisulfate
          Percutaneous Coronary Intervention
          Dual Antiplatelet Therapy
          Venous Thrombosis
          Human
          PubMed
          Cochrane Library
          Embase
          Confidence Intervals
          Bias (Research)
          Systematic Review
          Meta Analysis
          Chi Square Test
          Sensitivity and Specificity
      ab: Background: Coronary artery disease (CAD) is the leading cause of death worldwide. After percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is recommended to reduce thrombotic events. This meta-analysis assesses the effectiveness of clopidogrel compared to aspirin monotherapy following DAPT post-PCI. Methods: From inception to April 2025, an exhaustive literature search was conducted across electronic databases, including PubMed, Cochrane Library, ScienceDirect, EMBASE, and Web of Science. Risk ratios (RRs) along with 95% confidence intervals (CIs) were pooled using the random-effects model in Review Manager. Leave-one-out sensitivity analysis and funnel plots were used to evaluate heterogeneity and publication bias, respectively. Results: Six studies, including 3 RCTs and 3 observational studies, spanning over 19 494 patients, were included in our analysis. Clopidogrel significantly reduced major adverse cardiovascular events (MACE) (RR = 0.78; 95% CI: [0.69, 0.89]; P =.0002; I 2 = 0%) and myocardial infarction (MI) (RR = 0.73; 95% CI: [0.56, 0.94]; P =.02; I 2 = 21%) compared to aspirin. Likewise, the clopidogrel group demonstrated a substantial advantage in reducing the incidence of any stroke (RR = 0.66; 95% CI: [0.49, 0.89]; P =.006; I 2 = 14%), including ischemic stroke (RR = 0.69; 95% CI: [0.49, 0.97]; P =.04; I 2 = 0%). All other endpoints, including hemorrhagic stroke, all-cause mortality, cardiac death, major bleeding, stent thrombosis, repeat, and target vessel revascularization, were comparable between the 2 arms. Conclusion: Clopidogrel significantly reduced the incidence of MACE, MI, and stroke after DAPT following PCI compared to aspirin, indicating greater effectiveness. However, the main conclusion of this meta-analysis depends primarily on the estimates from RCTs. Additional randomized studies are necessary to confirm these results and support clinical decision-making.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        Journal Article
      ougenre: Article
    language: English
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