Woodward M, Lowe G D O, Francis L M A, Rumley A, Cobbe S M
Institute for International Health, University of Sydney, Sydney, Australia.
J Thromb Haemost. 2004 Nov;2(11):1934-40. doi: 10.1111/j.1538-7836.2004.01017.x.
A randomized, double-blind multicenter trial-the Clopidogrel and Aspirin: Determination of the Effects on Thrombogenicity (CADET) trial-was carried out to compare the effects of clopidogrel vs. aspirin on thrombotic variables and C-reactive protein (CRP), over a 6-month period of treatment, in patients with an acute myocardial infarction within the previous 3-7 days, who were not scheduled for major surgery including coronary artery bypass grafting. Patients (n = 184) were randomly allocated to aspirin (75 mg day(-1)) or clopidogrel (75 mg day(-1)). Blood samples were taken at baseline and then at clinic visits at 1, 3 and 6 months. By 1 month, clottable and immunonephelometric fibrinogen, D-dimer, von Willebrand factor, factor VIII and CRP were significantly (P < 0.05) reduced from baseline values in both treatment groups; as well as tissue plasminogen activator antigen in the aspirin group only. At 6 months, there were no differences between treatment groups (P > 0.05) for any of the variables, whether or not potential confounding variables were adjusted for. Similarly, there were no differences between treatments in the difference between baseline and final values for any of the variables. Aspirin and clopidogrel were thus found to have similar effects on thrombotic variables and CRP in this patient population.
一项随机、双盲多中心试验——氯吡格雷与阿司匹林:血栓形成性影响的测定(CADET)试验——开展以比较氯吡格雷与阿司匹林对血栓形成变量和C反应蛋白(CRP)的影响,在为期6个月的治疗期间,针对既往3至7天内发生急性心肌梗死且未计划进行包括冠状动脉搭桥术在内的大手术的患者。患者(n = 184)被随机分配至阿司匹林组(75毫克/天)或氯吡格雷组(75毫克/天)。在基线时采集血样,然后在第1、3和6个月的门诊就诊时采集。到第1个月时,两个治疗组中可凝和免疫比浊法检测的纤维蛋白原、D - 二聚体、血管性血友病因子、因子VIII和CRP均较基线值显著降低(P < 0.05);仅阿司匹林组的组织纤溶酶原激活物抗原也降低。在第6个月时,无论是否对潜在混杂变量进行调整,各变量在治疗组之间均无差异(P > 0.05)。同样,各变量在基线值与最终值之间的差异在治疗组之间也无差异。因此,在该患者群体中发现阿司匹林和氯吡格雷对血栓形成变量和CRP具有相似的作用。