Published 20 May 2009, doi:10.1136/bmj.b1928
Cite this as: BMJ 2009;338:b1928

Letters

Clopidogrel

Increasing concordance

The first 100% of the full text of this article appears below.

Chua and Ignaszewski review the evidence base for clopidogrel in acute coronary syndromes.1 Knowing the number needed to treat and number needed to harm for each trial would enable more informed decision making with patients.

For example, in the CURE trial the number needed to treat for the primary composite outcome was 48 and the number needed to harm for major bleeding (disabling, requiring transfusion) was 100. In other words, for every 100 patients treated for an average of 9 months with clopidogrel plus aspirin instead of aspirin alone, two non-fatal myocardial infarctions would be prevented at the expense of one major bleed caused. Overall, one positive outcome occurs for every 100 patients so treated. Is this explained to patients so a joint decision can be made (concordance) on whether to take clopidogrel as well as aspirin?

Cite this as: BMJ 2009;338:b1928

Peter D Burrill, specialist pharmaceutical adviser for public health1

1 Derbyshire County Primary Care Trust, Chesterfield S41 7PF

peter.burrill@derbyshirecountypct.nhs.uk

Competing interests: None declared.

  1. Chua D, Ignaszewski A. Clopidogrel in acute coronary syndromes. BMJ 2009;338:b1180. (14 April.)[Free Full Text]

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Relevant Article

Clopidogrel in acute coronary syndromes
Doson Chua and Andrew Ignaszewski
BMJ 2009 338: b1180. [Extract] [Full Text]

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