TEC: Evidence Based Therapeutics
Therapeutics Education Collaboration
Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 66: A clot, a clot, I want it not – secondary prevention with antiplatelets

In episode 66, we embark on a journey of epic proportions; at least relative to our understanding.  With the help of Peter Loewen, we outline the anti-platelet options in secondary prevention of heart disease.  We discuss at length the use ASA and clopidogrel but also touch on additional agents like warfarin, dipyridamole and others.  Where the evidence is clear, we create opacity and where it is gray, we go dark. Both Mike and Peter end up in a quagmire and James offers them help by throwing them a string of one-liners and a bottle of low-dose ASA.

Show Notes

Secondary prevention with antiplatelets

1) ATTC Meta-analysis – aspirin in primary and secondary resistance

Lancet 2009;373:1849–60

2) CURE trial – clopidogrel added to aspirin

NEJM 2001;345:494-502

3) Anti-platelets in patients with a history of vascular disease or other predisposing condition – absolute benefit – 3.6% over 2 years (combined CVD events)

BMJ 2002;324:71-86

4) Low-dose aspirin – absolute benefit – around 3.3% combined CVD events and 1.5% mortality over 3 yrs

Am J Med 2008;121:43-9

5) CHARISMA – Clopidogrel and aspirin vs aspirin

N Engl J Med 2006; 354:1706-17

6) Half of the benefit of clopidogrel occurs in the first month of use Clopidogrel for the treatment of adult patients following acute coronary syndrome

Therapeutics Initiative Review

Listening to this episode is for premium podcast members only. If you already have a membership, login to your account. If you aren't yet a premium subscriber, sign up today!

Search

BS Medicine Podcast

The 2024 MEME Conference – May 24-25, 2024

REGISTRATION COMING SOON

Making Evidence Matter For Everyone | May 24 & 25, 2024
From the clinicians who brought you the Best Science Medicine Course and the Meds Conference, as well as the BS Medicine Podcast and Tools for Practice

hectalks.com

BIG ANNOUNCEMENT

THE NUTRITION PROPOSITION BOOK

Check it out at nutritionproposition.com and think about picking up a copy on Amazon. All the evidence you ever wanted about nutrition and the only nutrition book that won’t tell you what to eat.

 

BedMed: The High Blood Pressure Study

This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)

PEER Tools

Search

Recent Posts

Archives

Categories

Meta