ArticleJournal of the American Heart Association2018
Comparison Between Aspirin and Clopidogrel in Secondary Stroke Prevention Based on Real-World Data.
Article in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- National Heart Center/Saudi Heart Association 2025 Guidelines for Cardiovascular Diseases Prevention and Risk Assessment.Saudi medical journal · 2026Guideline
- Benefits and Risks of Clopidogrel vs. Aspirin Monotherapy after Recent Ischemic Stroke: A Systematic Review and Meta-Analysis.Cardiovascular therapeutics · 2019Pooled it
- Prognostic implications of single antiplatelet therapy in individuals developing diabetic foot disease with concurrent peripheral arterial disease.Annals of medicine · 2026Article
- Review
- Article
- Daily Antiplatelets Other Than Aspirin Reduce Liver Cancer Risk but Increase Intracranial Hemorrhage Risk in Cirrhotic Patients.International journal of general medicine · 2024Article
- Antiplatelet Treatment Patterns and Outcomes for Secondary Stroke Prevention in the United Kingdom.Cardiology and therapy · 2023Article
- Antiplatelet treatment patterns and outcomes of secondary stroke prevention in the United States.Heliyon · 2023Article
- Outcomes of a multi-ethnic Asian population on combined treatment with clopidogrel and omeprazole in 12,440 patients.Journal of thrombosis and thrombolysis · 2021Review
- Cost Effectiveness of Genotype-Guided Antiplatelet Therapy in Asian Ischemic Stroke Patients: Ticagrelor as an Alternative to Clopidogrel in Patients with CYP2C19 Loss of Function Mutations.Clinical drug investigation · 2020Article
- Body weight, CYP2C19, and P2Y12 receptor polymorphisms relate to clopidogrel resistance in a cohort of Chinese ischemic stroke patients with aspirin intolerance.European journal of clinical pharmacology · 2020Article
- Efficacy and safety of clopidogrel and aspirin do not differ in patients with stable ischemic stroke.Journal of the Chinese Medical Association : JCMA · 2020Article
- Aspirin Versus Clopidogrel Monotherapy for the Secondary Prevention of Recurrent Cerebrovascular Attack Following Previous Ischemic Stroke in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Article
- CYP2C19 loss-of-function alleles: A common but overlooked problem associated with clopidogrel resistance.Journal of the Chinese Medical Association : JCMA · 2019Article
- Article
- Comparison Between Aspirin and Clopidogrel in Secondary Stroke Prevention Based on Real-World Data.Journal of the American Heart Association · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Clopidogrel was thought to be superior to aspirin for secondary prevention of vascular diseases in clinical trials. In this study we assessed the safety and efficacy of clopidogrel versus aspirin in real-world practice by using the Taiwan Stroke Registry. Methods and Results Patients with ischemic stroke (2006-2016) on aspirin or clopidogrel for secondary stroke prevention were identified in the Taiwan Stroke Registry. Stroke recurrence and mortality rates in patients receiving aspirin (N=34 679) were compared with those receiving clopidogrel (N=7611) during a 12-month follow-up period. Propensity score matching and conditional Cox proportional hazards regression model were applied to control confounding factors with 6443 patients in each group. After propensity score matching, stroke recurrence rates were comparable between groups, with 223 patients in the aspirin (3.46%) and 244 in the clopidogrel group (3.79%) (hazard ratio=1.13, 95% confidence interval=0.89-1.43, P=0.311). However, the mortality rate was significantly higher in the clopidogrel group (362 patients, 5.62%) than in the aspirin group (302 patients, 4.69%) (hazard ratio=1.30, 95% confidence interval=1.07-1.58, P=0.008). Results were consistent before and after propensity score matching. Conclusions Clopidogrel was as effective as aspirin for prevention of recurrent stroke in real-world practice. However, the mortality rate was significantly higher in the clopidogrel than in the aspirin group.
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