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Monotherapy with a P2Y12 inhibitor or aspirin for secondary prevention in patients with established atherosclerosis: a systematic review and meta-analysis. Lancet 2020; 395: 1487-1495.

Published: 22nd July 2020

Authors: Chiarito M, Sanz-Sanchez J, Cannata F, Cao D, Sturla M, Panico C et al.


There were nine RCTs that included over 42,000 patients. Compared with aspirin, use of a P2Y12 inhibitor (usually clopidogrel) had a borderline improvement in reducing myocardial infarction (odds ratio 0.81, 95 per cent confidence interval 0.66 to 0.99), but other effects on risk reduction (for stroke, death and vascular death) were similar.

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