Patients With Prior Myocardial Infarction, Stroke, or Symptomatic Peripheral Arterial Disease in the CHARISMA Trial

• Published in: Journal of the American College of Cardiology Vol. 49; no. 19; pp. 1982 - 1988
• Main Authors: Bhatt, Deepak L., MD, FACC, Flather, Marcus D., MD, Hacke, Werner, MD, Berger, Peter B., MD, FACC, Black, Henry R., MD, Boden, William E., MD, FACC, Cacoub, Patrice, MD, Cohen, Eric A., MD, Creager, Mark A., MD, FACC, Easton, J. Donald, MD, Hamm, Christian W., MD, FACC, Hankey, Graeme J., MD, Johnston, S. Claiborne, MD, PhD, Mak, Koon-Hou, MD, FACC, Mas, Jean-Louis, MD, Montalescot, Gilles, MD, PhD, Pearson, Thomas A., MD, FACC, Steg, P. Gabriel, MD, FACC, Steinhubl, Steven R., MD, FACC, Weber, Michael A., MD, FACC, Fabry-Ribaudo, Liz, MSN, RN, Hu, Tingfei, MS, Topol, Eric J., MD, FACC, Fox, Keith A.A., MBChB
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.05.2007; Elsevier Science; Elsevier Limited
• Subjects: Acute coronary syndromes; Aged; Aspirin; Aspirin - administration & dosage; Biological and medical sciences; Blood and lymphatic vessels; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Confidence intervals; Coronary heart disease; Coronary vessels; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Double-Blind Method; Drug therapy; Drug Therapy, Combination; Female; Follow-Up Studies; Heart; Heart attacks; Hospitalization; Humans; Internal Medicine; Male; Medical sciences; Middle Aged; Mortality; Multivariate analysis; Myocardial Infarction - drug therapy; Myocarditis. Cardiomyopathies; Neurology; Nitrates; Peripheral Vascular Diseases - drug therapy; Platelet Aggregation Inhibitors - administration & dosage; Population; Risk factors; Stroke - drug therapy; Ticlopidine - administration & dosage; Ticlopidine - analogs & derivatives; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; PAD; CI; myocardial infarction; hazard ratio; confidence interval; HR; peripheral arterial disease; MI; Human; Myocardial infarction; Nervous system diseases; Stroke; Lower limb; Cardiovascular disease; Patient; Myocardial disease; Phlebology; Cerebral disorder; Arterial disease; Vascular disease; Heart disease; Central nervous system disease; Occlusive arterial disease; Clinical trial; Circulatory system; Cardiology; Cerebrovascular disease
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.03.025

Patients With Prior Myocardial Infarction, Stroke, or Symptomatic Peripheral Arterial Disease in the CHARISMA Trial Deepak L. Bhatt, MD, FACC, Marcus D. Flather, MD, Werner Hacke, MD, Peter B. Berger, MD, FACC, Henry R. Black, MD, William E. Boden, MD, FACC, Patrice Cacoub, MD, Eric A. Cohen, MD, Mark A. Creager, MD, FACC, J. Donald Easton, MD, Christian W. Hamm, MD, FACC, Graeme J. Hankey, MD, S. Claiborne Johnston, PhD, MD, Koon-Hou Mak, MD, FACC, Jean-Louis Mas, MD, Gilles Montalescot, MD, PhD, Thomas A. Pearson, MD, FACC, P. Gabriel Steg, MD, FACC, Steven R. Steinhubl, MD, FACC, Michael A. Weber, MD, FACC, Liz Fabry-Ribaudo, MSN, RN, Tingfei Hu, MS, Eric J. Topol, MD, FACC, Keith A. A. Fox, MBChB, for the CHARISMA Investigators Dual antiplatelet therapy with clopidogrel plus aspirin has already been validated in the settings of acute coronary syndromes and coronary stenting. We identified 9,478 patients in the CHARISMA (Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance) trial who were enrolled with documented prior myocardial infarction (MI), ischemic stroke, or symptomatic peripheral arterial disease. The median duration of follow-up was 27.6 months. The rate of cardiovascular death, MI, or stroke was significantly lower in the clopidogrel plus aspirin arm than in the placebo plus aspirin arm: 7.3% versus 8.8% (hazard ratio 0.83, 95% confidence interval 0.72 to 0.96, p = 0.01); this benefit persisted after multivariate modeling and was not dependent on the time from the ischemic event.