1. The Case for Clopidogrel Only

2. Focus
• Comfort
• Cost
• Side Effects

3. Comfort – CURE
12,562 pts with NSTE-ACS
NEJM 2001;345: 494-502.

4. Comfort – PCI CURE
Lancet 2001; 358: 527–33.

5. Comfort - COMMIT
45,852 acute MI patients
87% were STEMI
Lancet 2005; 366: 1607–21.

6. Comfort – Comparison

7. Cost – Clopidogrel
30 days 90 days 1 year
Clopidogrel $13.87 $22.82 $111.43
Prasugrel $211.83 $627.85 $2546.28
Ticagrelor $255.76 $756.79 $3053.18
GoodRx.com; Accessed 9/12/2012

8. Relative Cost

9. Relative Cost

10. Bleeding - CURE
12,562 pts with NSTE-ACS

11. Fatal Bleeding Comparison
TRITON
NEJM 2007;357:2001-15.

12. Bleeding Comparison
PLATO
Non-CABG related Bleeding, study defined
NEJM 2009;361:1045-57.

13. Dyspnea
PLATO
NEJM 2009;361:1045-57.

14. Ventricular Pauses
PLATO
NEJM 2009;361:1045-57.

15. Conclusions
• Clopidogrel is easy and comfortable to use
• Clopidogrel is extremely less expensive
compared to the newer agents
• Clopidogrel doesn’t increase fatal bleeding,
dyspnea, or ventricular pauses