For prevention of vascular events, is clopidogrel and aspirin non-inferior to oral anticoagulation therapy? Active-W Trial (re-post)

The Bottom Line: Oral anticoagulation is superior to clopidogrel plus aspirin in preventin vascular events in those with atrial fibrillation at high risk for stroke, particularly in patients already taking oral anticoagulation.

Connolly Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006 vol:367 iss:9526 pg:1903 -1912

Summary: As aspirin has a protective effect in atrial fibrillation, it’s reasonable to expect that adding clopidogrel to aspirin will provide incremental benefits and this combination would be non-inferior to oral anticoagulation in preventing vascular events. The trial aimed to assess whether clopidogrel plus aspirin was statistically non-inferior to oral anticoagulation for prevention of vascular events in those with atrial fibrillation at high risk of stroke and eligible for oral anticoagulation therapy.

Re-post from Oct 19, 2011

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