3-1. 3-2 Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk.

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Presentation transcript:

3-1

3-2 Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients Antithrombotic Trialists’ Collaboration (N = 212,000 in 287 trials) BMJ 324:71–86, 2002

3-3 Antithrombotic Trialists Collaboration, BMJ 324:71–86, 2002 Odds Ratio & 95% CI Antiplatelet Worse Antiplatelet Better < 75 ASA Dose (mg) 14.5% 11.5% 10.9% 17.3% 12.9% Any Aspirin Anti-plateletControl 17.2% 14.8% 15.2% 19.4% 16.0% No. of Trials Odds  : 19% 26% 32% 13% 23% Treatment effect p < Antiplatelet Meta-Analysis Endpoints: MI, Stroke, Vascular Death

3-4 Primary Endpoint: MI, stroke or CV death % of Patients with primary endpoint p=0.003; 200mg p=0.001 CURE Placebo+ASA Arm CURE Placebo+ASA Arm N=3,115 N=4,172 N=5,259  100mg 110–162mg  200mg

3-15 Major Bleeding (including Life-Threatening) CURE Study: Placebo+ASA Arm % of Patients with Event Source: Cure Study  100mg 110–162mg  200mg

Jan-D-8 Improved Compliance with Combination Tablet vs. Dual Therapy Diabetes 1 : –21% improvement in tablet consumption over 6 month period in previously treated patients Hypertension: –13% improvement in tablet consumption over 12 month period 2 –11% improvement in prescription renewal over 12 month period 3 HIV 4 : –9% reduction in missing even one dose over 16 week period 1 White & Hopson (2002) Clin Ther - in press 2 White & Hopson (2002) in press 3 Dezii (2000) Manag. Care 4 Eron et al (2000) AIDS