CLASSICS (Clopidogrel Aspirin Stent International Cooperative Study)

18 Mar, 14

Aim

To evaluate safety of clopidogrel in combination with aspirin compared with ticlopidine in combination with aspirin in patients who had undergone successful coronary stenting

Study Patients & Treatment

Patients who had undergone successful coronary stenting received 28 days of treatment with either (N = 1020):

300 mg clopidogrel (loading dose) and 325 mg/d aspirin on day 1, followed by 75 mg/d clopidogrel and 325 mg/d aspirin (days 2 to 28)
75 mg/d clopidogrel and 325 mg/d aspirin (days 1 to 28)
250 mg bid ticlopidine and 325 mg/d aspirin (days 1 to 28)

Results

Incidence of bleeding complications, neutropenia, thrombocytopenia, or early discontinuation due to non cardiac event (e.g. skin disorder, gastrointestinal disorder, allergy) was 50% less in the clopidogrel group as compared to the ticlopidine group.
Efficacy rates were comparable between the two groups.

Conclusion

Thus the safety/tolerability of clopidogrel (plus aspirin) is superior to that of ticlopidine (plus aspirin). The 300 mg loading dose was also well tolerated, with no increased risk of bleeding.

Circulation 2000; 102: 624-629