In patients with diabetes, are clopidogrel and ticlopidine effective for primary and secondary prevention of cardiovascular disease?

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EVIDENCE-BASED ANSWERIn patients with diabetes and cardiovascular disease (CVD), adenosine diphosphate (ADP) receptor antagonists (ticlopidine and clopidogrel) do not reduce all-cause mortality, vascular mortality, or myocardial infarction (MI) compared with placebo (SOR: B, individual RCT). In patients with diabetes and CVD or CVD risk factors, ADP receptor antagonists, alone or in combination with aspirin, do not reduce the combined risk of stroke, MI, and vascular mortality more than aspirin alone (SOR: B, individual RCTs).

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