Clopidogrel might be better than aspirin for long-term heart disease

Medical Xpress / The Lancet ^ | Sept. 1, 2025 | Marco Valgimigli et al

[ConservativeMind]

A comprehensive analysis of nearly 29,000 patients with coronary artery disease (CAD) suggests that clopidogrel, a commonly prescribed blood thinner, is more effective than aspirin in preventing serious heart and stroke events, without increasing the risk of major bleeding.

The new study challenges the long-standing recommendation of aspirin as the default treatment for secondary prevention in CAD patients.

CAD, a condition characterized by narrowed heart arteries, often requires lifelong treatment to prevent heart attacks, strokes, and cardiovascular death. Aspirin has traditionally been prescribed indefinitely for patients with CAD. However, the evidence supporting aspirin's long-term benefits and safety has been limited.

This new analysis of seven clinical trials found that patients taking clopidogrel had a 14% lower risk of major adverse cardiovascular or cerebrovascular events (including heart attack, stroke, or cardiovascular death) compared to those taking aspirin. Importantly, the rates of major bleeding were similar between the two drugs, dispelling concerns that clopidogrel might lead to more bleeding complications.

The analysis drew from diverse patient groups, including those who had undergone procedures like stent placement or had experienced acute coronary syndrome, and examined various subgroups to ensure the findings applied broadly. Notably, even patients who might respond less well to clopidogrel due to genetic or clinical factors still benefited from its use over aspirin.

These results suggest that clopidogrel should be considered the preferred long-term antiplatelet medication for patients with established coronary artery disease.

The authors say that because both medications are widely available, the study's findings have the potential to influence clinical guidelines worldwide and improve patient outcomes.

[ConservativeMind]

Clopidogrel appears to cause 14% fewer major adverse cardiovascular or cerebrovascular events than does aspirin, for people using them to reduce coronary artery disease risk.

It costs under $9 a month, on one free benefit plan.

[ConservativeMind]

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[Biblebelter]

Had a widow maker heart attack in 2002 even though I had no risk factors and was not on any medication.

It was called Plavix then.

I had a catherization in 2019 based on a stress test.

They put a stent in on the right but the original stents put in on the left were still “clean”.

Besides this blood thinner, I have also taken a beta blocker and an ace inhibitor ever since my heart attack in 2002.

All my prescriptions have turned generic and they are cheap “miracle” drugs in my opinion.

[telescope115]

I was on Clopidogrel for a few years after my liver transplant. It is a powerful blood thinner. Whenever I had blood drawn they had to wrap the injection site, and a while later I could remove the bandage. My electric razor broke, so I had to resort to using a blade razor again. One time I cut my chin shaving and it was 18 hours before it stopped. I had to sleep with my chin all bandaged up, lol.

They finally took me off of it. I just take baby aspirin now, every morning, along with everything else.

My advice to anyone taking it is BE CAREFUL with razors, knives in the kitchen, etc, etc, etc.

[Tuxedo]

Had atrial flutter and NSTEMI in July and on Plavix after a stent to LCx and beta blocker, lipitor, eliquis, and losartan. Hopefully this combo keeps future events away. Fairly inexpensive with insurance. Feel great but beta blocker makes me a little more tired than usual.

[Biblebelter]

I take half a tab of losartan daily and the generic for lipitor as well.

I also take a multivitamin plus an extra 500 mg of vitamin C and 5000iu of vitamin D3.

I walk a mile one day and twenty minutes the next day on my treadmill which is all an arthritic knee will allow for.

I eat a very healthy breakfast and light lunch.

I eat pretty much what I feel like at dinner, but don’t overdo the quantity.

Going on seventy-five and I feel my quality of life is quite good.