Abstract 2220: The Relative Safety and Efficacy of Clopidogrel in Women and Men: Meta-Analysis of 79,613 Patients Enrolled in CREDO, CURE, CLARITY-TIMI 28, COMMIT, and CHARISMA
Bibliographic record
Abstract
Background : Previous analyses have demonstrated sex-based differences in the efficacy of several anti-platelet medications. Little is known about the safety and efficacy of clopidogrel in women and men. Methods : We performed a meta-analysis of all blinded randomized clinical trials comparing clopidogrel and placebo (CREDO, CURE, CLARITY-TIMI 28, COMMIT, and CHARISMA). The relative safety and efficacy of clopidogrel at reducing cardiovascular events (death, MI or stroke) in women and men was estimated using random-effects modeling. Results : In all 79,613 patients, there was a reduction of cardiovascular events with clopidogrel vs placebo (9.7% vs 8.7%; OR 0.88 [0.84–0.93], P<0.01). Among the 23,522 women enrolled, there were 1289/11757 (11.0%) cardiovascular events in the clopidogrel group vs. 1372/11766 (11.7%) in the placebo group (OR 0.93 [0.86–1.01], P=0.09). Clopidogrel had its greatest effect in reducing the risk of MI (OR 0.82 [0.70–0.95], P=0.01) in women. No significant reduction was noted for stroke (OR 0.91 [0.67–1.24], P=0.56) or death (OR 0.99 [0.90–1.08], P=0.78). Among the 56,091 men enrolled, there were 2166/28064 (7.7%) cardiovascular events in the clopidogrel group vs 2492/28027 (8.9%) in the placebo group (OR 0.85 [0.79–0.91], P<0.01). Clopidogrel significantly reduced the risk of MI (OR 0.84 [0.76–0.92], P<0.01), stroke (OR 0.83 [0.71–0.96], P=0.01), and death (OR 0.91 [0.84–0.98], P<0.01). Clopidogrel increased the risk of major bleeding in both women (1.6% vs 1.1%, OR 1.43 [1.14–1.79]) and men (1.2% vs 1.0%, OR 1.21 [1.03–1.42]). The safety and efficacy were similar in patients with an acute coronary syndrome and established cardiovascular disease. There was no evidence of statistical heterogeneity (as measured by the Q-test and I 2 ) in pooled analyses comparing women and men for the composite endpoint, its individual components, or bleeding. Conclusions : Clopidogrel reduces the risk of cardiovascular events in both women and men. While the directionality and proportionality of the reductions are roughly similar, the effect was driven by a reduction of MI in women. The reduction of MI, stroke and death by clopidogrel in men were all significant. Clopidogrel increased the risk of major bleeding by 43% in women and 21% in men.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.020 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.014 | 0.054 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".