• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan+
  • Wellness
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan+
  • Wellness
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics General Medicine Classics

The CURE trial: Clopidogrel in ACS without ST-elevation [Classics Series]

byAndrew Cheung, MD MBA
September 25, 2014
in General Medicine Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. The addition of clopidogrel significantly reduced the risk of death from cardiovascular causes, nonfatal myocardial infarction, or other ischemic events in patients with ACS without ST elevation.

2. Adding clopidogrel is associated with significantly higher risk of major and minor bleeding, but not life-threatening bleeding.

Original Date of Publication: August 16, 2001

Study Rundown: Acute coronary syndrome (ACS) refers to symptoms that may be attributed to the occlusion of coronary arteries. Common symptoms include chest pain radiating to the jaw or arms, shortness of breath, sweating, and a pressure-like sensation on the chest, resulting from myocardial ischemia or infarction. ST-segment changes are often used to classify ACS, with ST-elevation suggesting a transmural infarct – these are often treated with immediate revascularization. Patients suffering ACS without ST-elevation often do not undergo urgent revascularization. Prior to the Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) trial, therapy for ACS without ST-elevation consisted mainly of aspirin and heparin. The purpose of the CURE trial, published in 2001, was to explore whether the addition of clopidogrel, a thienopyridine class antiplatelet agent, could further reduce the risk of recurrent ischemic events in patients suffering from ACS without ST-elevation.

This study demonstrated the benefit of adding clopidogrel to aspirin and other medications for the treatment of patients with acute coronary syndromes without ST-segment elevation. Treatment with clopidogrel resulted in a significantly lower risk of death from cardiovascular causes, nonfatal myocardial infarction, or stroke compared to placebo (RR 0.80; 95%CI 0.72-0.90). Of note, the addition of clopidogrel resulted in significantly higher rates of major (RR 0.80; 95%CI 0.72-0.90) and minor bleeding complications, though not life-threatening bleeds. Based on the findings of this study, clopidogrel is widely used, in addition to aspirin, heparin, and other medications, in managing patients with ACS.

Click to read the study in NEJM

RELATED REPORTS

Ticagrelor monotherapy reduces bleeding risk compared to dual antiplatelet therapy for patients following coronary stenting

#VisualAbstract: Clopidogrel plus aspirin reduces new stroke risk but increases bleeding risk compared to aspirin alone following ischemic stroke

Clopidogrel associated with better cardiovascular outcomes compared with aspirin in patients with and without diabetes – A post hoc analysis of the HOST-EXAM trial

In-Depth [randomized, controlled study]: This randomized, controlled trial compared clopidogrel with placebo in addition to aspirin in patients presenting with acute coronary syndromes without ST-segment elevation. Patients were eligible for the trial if they were hospitalized within 24 hours of symptom onset and did not have ST-segment elevation. Patients with contraindications to antithrombotic or antiplatelet therapy, at high risk of bleeding or severe heart failure, taking oral anticoagulants, and those who had revascularization in the past three months or glycoprotein IIb/IIIa inhibitors in the past 3 days were excluded. The first primary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or stroke. The second primary outcome was the composite of the first primary outcome with refractory ischemia. Severe ischemia, heart failure and need for revascularization were secondary outcomes and other outcomes were bleeding complications categorized as life-threatening, major, or minor.

A total of 12,562 patients from 482 centres in 28 countries were enrolled in the trial. Patients in the clopidogrel group experienced significantly lower rates of the first primary outcome, when compared with patients receiving placebo (RR 0.80; 95%CI 0.72-0.90). The rate of the second primary outcome was also significantly lower in patients treated with clopidogrel (RR 0.86; 95%CI 0.79-0.94). Significantly fewer patients in the clopidogrel group experienced severe ischemia (RR 0.74; 95%CI 0.61-0.90) or recurrent angina (RR 0.91; 95%CI 0.85-0.98). Major bleeding, defined as bleeding requiring transfusion of two or more units of blood, was significantly more common in the clopidogrel group (RR 1.38; 95%CI 1.13-1.67).

Image: PD

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.

Tags: acute coronary syndromesclopidogrelcure trial
Previous Post

Paternal factors found to significantly influence certain adolescent sexual behaviours

Next Post

Preterm boys cognitively catch up to their peers by age 7, while girls lag behind

RelatedReports

Drug-coated balloons are noninferior to drug-eluting stents for treatment of small vessel coronary artery disease
Cardiology

Ticagrelor monotherapy reduces bleeding risk compared to dual antiplatelet therapy for patients following coronary stenting

September 25, 2024
#VisualAbstract: Clopidogrel plus aspirin reduces new stroke risk but increases bleeding risk compared to aspirin alone following ischemic stroke
StudyGraphics

#VisualAbstract: Clopidogrel plus aspirin reduces new stroke risk but increases bleeding risk compared to aspirin alone following ischemic stroke

January 9, 2024
Patient Basics: Atherosclerosis
Cardiology

Clopidogrel associated with better cardiovascular outcomes compared with aspirin in patients with and without diabetes – A post hoc analysis of the HOST-EXAM trial

April 27, 2023
The ABCD2 score: Risk of stroke after Transient Ischemic Attack (TIA) [Classics Series]
Neurology Classics

POINT trial: Clopidogrel and Aspirin for Acute Ischemic Stroke [Classics Series]

September 14, 2022
Next Post

Preterm boys cognitively catch up to their peers by age 7, while girls lag behind

Neonatal care not associated with early developmental delays in children born late preterm

Lomitapide reduces LDL-C by 38% in patients with devastating homozygous familial hypercholesterolemia

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Increased tirzepatide use for glycemic and weight control since United States market entry
  • Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism
  • 2 Minute Medicine Rewind April 14, 2025
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.