The Case for Clopidogrel Only

Focus

• Comfort• Cost• Side Effects

Comfort – CURE

NEJM 2001;345: 494-502.

12,562 pts with NSTE-ACS

Comfort – PCI CURE

Lancet 2001; 358: 527–33.

Comfort - COMMIT

Lancet 2005; 366: 1607–21.

45,852 acute MI patients87% were STEMI

Comfort – Comparison

Cost – Clopidogrel

30 days 90 days 1 year

Clopidogrel $13.87 $22.82 $111.43

Prasugrel $211.83 $627.85 $2546.28

Ticagrelor $255.76 $756.79 $3053.18

GoodRx.com; Accessed 9/12/2012

Relative Cost

Relative Cost

Bleeding - CURE12,562 pts with NSTE-ACS

Fatal Bleeding Comparison

NEJM 2007;357:2001-15.

TRITON

Bleeding Comparison

NEJM 2009;361:1045-57.

Non-CABG related Bleeding, study definedPLATO

Dyspnea

NEJM 2009;361:1045-57.

PLATO

Ventricular Pauses

NEJM 2009;361:1045-57.

PLATO

Conclusions

• Clopidogrel is easy and comfortable to use• Clopidogrel is extremely less expensive

compared to the newer agents• Clopidogrel doesn’t increase fatal bleeding,

dyspnea, or ventricular pauses