Is clopidogrel plus aspirin superior to aspirin alone for primary prevention of cardiovascular outcomes among patients with multiple risk factors?

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Abstract

EVIDENCE-BASED ANSWER

No, clopidogrel plus aspirin (ASA) is not better than ASA alone for primary prevention of cardiovascular outcomes among patients with multiple risk factors, and this combination therapy increases the risk of bleeding (SOR: B, RCT). ASA alone is recommended for primary prevention in patients aged 50 to 59 years old with a 10-year risk of cardiovascular disease (CVD) of 10% or more and a low bleeding risk; ASA is recommended selectively in patients 60 to 69 years old (SOR: C, expert opinion).

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