Claudio Laudani: A Striking Geographic Heterogeneity in Aspirin and Clopidogrel Comparison for MACE Prevention
Claudio Laudani, Former Postdoctoral Researcher at UF Health Jacksonville, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in European Heart Journal, adding:
”Recent studies have suggested that clopidogrel may be superior to aspirin for secondary prevention of major adverse cardiovascular events (MACE).
However, most of the available evidence comes from trials conducted in East Asia, raising important questions about the generalizability of these findings to Western populations.
In our study, we compared aspirin and clopidogrel according to patient ethnicity and found a striking geographic heterogeneity in treatment effect.
The apparent benefit of clopidogrel was driven almost entirely by East Asian trials, whereas results from Western studies were largely neutral.
Among East Asian patients, clopidogrel was associated with:
- 24% reduction in MACE
- 27% reduction in NACE
- 30% reduction in myocardial infarction
By contrast, no significant differences were observed among non–East Asian patients, with significant interaction observed for both MACE and all-cause mortality.
These findings underscore the need for caution when extrapolating results across populations.
Differences in drug metabolism, ischemic risk, and bleeding profiles may substantially influence the balance between aspirin and clopidogrel in different ethnic groups.
Further global studies are needed to better define the optimal antiplatelet strategy across diverse patient populations.”
Title: Aspirin vs clopidogrel in chronic coronary syndromes: a meta-analysis of ethnic differences Get access Arrow
Authors: Claudio Laudani, Giovanni Occhipinti, Francesco Costa, Domenico D’Amario, Tullio Palmerini, Sebastiano Sciarretta, Charles Michael Gibson, Behnood Bikdeli, Felicita Andreotti, Young-Hoon Jeong, Takeshi Kimura, Diana A. Gorog, Dirk Sibbing, Davide Capodanno, Jurrien ten Berg, Raffaele De Caterina, Mattia Galli
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