(Circulation. 2001;104:e9019.)
© 2001 American Heart Association, Inc.
Circulation Newswriter
CURE Trial Shows Benefit in Patients With Acute Coronary Syndrome
Patients who received the anti-clotting drug clopidogrel along with aspirin when exhibiting the symptoms of acute coronary syndromes without ST-segment elevation were less likely to die, have a nonfatal heart attack, or stroke. However, use of the drug was associated with a higher risk of bleeding, said the Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) trial Investigators in a report that appeared in the August 16, 2001 issue of the New England Journal of Medicine (2001;345:494-502).
The investigators randomly assigned 12 562 patients who arrived at the hospital within 24 hours of symptom onset to receive clopidogrel immediately or placebo in addition to aspirin for 3 to 12 months. The treatment group received 300 mg of clopidogrel immediately, followed by 75 mg once daily.
In the treatment group, 9.3% of patients died, experienced a nonfatal heart attack, or a stroke compared with 11.4 % in the placebo group. The relative risk with clopidogrel compared with placebo was 0.80. Patients in the clopidogrel group were significantly less likely to suffer from severe or refractory ischemia or heart failure or to need revascularization procedures.
However, the investigators warned that 3.7% patients in the clopidogrel group suffered major bleeding compared with 2.7% in the placebo group. However, the number of life-threatening bleeding episodes in the 2 groups did not differ significantly.
The authors concluded that treatment with clopidogrel and aspirin had benefits for patients with acute coronary syndromes without ST-segment elevation.
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