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(Circulation. 2002;106:2284.)
© 2002 American Heart Association, Inc.

Current Perspective

Clinical Implications of Percutaneous Coronary Intervention-Clopidogrel in Unstable angina to prevent Recurrent Events (PCI-CURE) Study

A US Perspective

Peter B. Berger, MD; Steven Steinhubl, MD

From the Division of Cardiovascular Medicine, Mayo Clinic, Rochester, Minn (P.B.B.); and the Division of Cardiology, University of North Carolina, Chapel Hill (S.S.).

Correspondence to Peter B. Berger, MD, Division of Cardiovascular Diseases-West 16, Mayo Clinic, 200 First St S.W., Rochester, MN 55905. E-mail berger.peter@mayo.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The long-term use of both aspirin and clopidogrel for patients with an acute coronary syndrome was analyzed in the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study.¹ In that trial, 12 562 patients with an acute coronary syndrome were randomly assigned to receive aspirin and clopidogrel or aspirin and placebo for a period of no more than 1 year. The results of the trial after a mean duration of follow-up of 9 months revealed an approximately 20% relative reduction in the risk of vascular death, myocardial infarction, and stroke. There were 2658 patients (21%) who underwent percutaneous coronary intervention (PCI) in the CURE trial a median of 10 days after enrollment. This was decided not by study protocol but by physician preference, which was influenced by the therapy to which patients were randomized; among these patients, the reduction in events (cardiovascular death, myocardial infarction [MI], or an urgent repeat revascularization procedure) from the PCI procedure through 30 days was an absolute1.9% (6.4% versus 4.5%), which was a relative reduction of 30% (P=0.03).² From the time of PCI through the remainder of follow-up, there was an absolute reduction in cardiovascular (CV) death and MI of 2% (8.0% versus 6.0%), which was a relative risk reduction of 25% (P=0.047).

Although dual antiplatelet therapy with clopidogrel and aspirin is often considered to be of benefit only in patients treated with stents, an interesting finding in PCI-CURE was that pretreatment and continued therapy with clopidogrel appeared to be . . . [Full Text of this Article]

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