|Class of recommendation||Level of evidence|
|I: Evidence and/or general agreement that a given diagnostic procedure/treatment is beneficial, useful, and effective||A: Data derived from multiple randomized clinical trials or meta-analyses|
|IIa: Conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of the treatment with the weight of evidence in favour||B: Data derived from a single randomized clinical trial or large nonrandomized studies|
|IIb: Conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of the treatment with the usefulness/efficacy less well established||C: Consensus of opinion by experts and/or small studies, retrospective studies, and registries|
|III: Evidence that the treatment is not useful and in some cases may be harmful|
Role of the Funding Source
Antiplatelet Therapy for Secondary Prevention in the First Year Following an Acute Coronary Syndrome
Antiplatelet Therapy for Secondary Prevention in the First Year Following PCI
Antiplatelet Therapy for Secondary Prevention Beyond 1 Year Following ACS or PCI
Antiplatelet Therapy for Secondary Prevention Following CABG
- Eagle K.A.
- Guyton R.A.
- Davidoff R.
- et al.
- Fox K.A.
- Mehta S.R.
- Peters R.
- et al.
Antiplatelet Therapy for the Secondary Prevention of Cerebrovascular Disease
Antiplatelet Therapy for Vascular Prevention in Patients With PAD
- Freiberg M.S.
- Arnold A.M.
- Newman A.B.
- Edwards M.S.
- Kraemer K.L.
- Kuller L.H.
Antiplatelet Therapy for the Primary Prevention of Vascular Events
Use of Antiplatelet Therapy in Patients With Diabetes
- Wiviott S.D.
- Braunwald E.
- Angiolillo D.J.
- et al.
Use of Antiplatelet Therapy in Patients With HF
Use of Antiplatelet Therapy in Patients With Chronic Kidney Disease
- Dasgupta A.
- Steinhubl S.R.
- Bhatt D.L.
- et al.
- Wiviott S.D.
- Braunwald E.
- McCabe C.H.
- et al.
Use of Antiplatelet Therapy in Women Who Are Pregnant or Breastfeeding
Management of Patients on Antiplatelet Therapy Who Require a Surgical or Other Invasive Procedure
Management of Antiplatelet Therapy in Association With Minor Bleeding
Combination Therapy With Warfarin and ASA: When to Use, When to Consider, When to Avoid
Interaction Between Clopidogrel and Proton Pump Inhibitors
- Abraham N.S.
- Hlatky M.A.
- Antman E.M.
- et al.
- Abraham N.S.
- Hlatky M.A.
- Antman E.M.
- et al.
Interaction Between ASA and Nonsteroidal Anti-Inflammatory Drugs
- Canadian Cardiovascular Society Consensus Conference: peripheral arterial disease - executive summary.Can J Cardiol. 2005; 21: 997-1006
- Management of cardiovascular disease in patients with diabetes: the 2008 Canadian Diabetes Association guidelines.CMAJ. 2008; 179: 920-926
- The Canadian Association of Interventional Cardiology and the Canadian Cardiovascular Society joint statement on drug-eluting stents.Can J Cardiol. 2007; 23: 121-123
- Toward a more effective approach to stroke: Canadian Best Practice Recommendations for Stroke Care.CMAJ. 2008; 178: 1418-1425
- Canadian Cardiovascular Society guidelines on the use of antiplatelet therapy in the outpatient setting.Can J Cardiol. 2011; (In press)
- Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.Qual Saf Health Care. 2003; 12: 18-23
- Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation.N Engl J Med. 2001; 345: 494-502
- Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation.N Engl J Med. 2005; 352: 1179-1189
- Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial.Lancet. 2005; 366: 1607-1621
- Prasugrel versus clopidogrel in patients with acute coronary syndromes.N Engl J Med. 2007; 357: 2001-2015
- Ticagrelor versus clopidogrel in patients with acute coronary syndromes.N Engl J Med. 2009; 361: 1045-1057
- Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study.Lancet. 2001; 358: 527-533
- Effect of clopidogrel pretreatment before percutaneous coronary intervention in patients with ST-elevation myocardial infarction treated with fibrinolytics: the PCI-CLARITY study.JAMA. 2005; 294: 1224-1232
- Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial.JAMA. 2002; 288: 2411-2420
- Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study.Lancet. 2010; 375: 283-293
- Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting versus bare-metal stents.J Am Coll Cardiol. 2006; 48: 2584-2591
- Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry.Circulation. 2006; 113: 2803-2809
- Effectiveness of two-year clopidogrel + aspirin in abolishing the risk of very late thrombosis after drug-eluting stent implantation (from the TYCOON [two-year ClOpidOgrel need] study).Am J Cardiol. 2009; 104: 1357-1361
- Duration of dual antiplatelet therapy after implantation of drug-eluting stents.N Engl J Med. 2010; 362: 1374-1382
- Aspirin, sulfinpyrazone, or both in unstable angina: results of a Canadian multicenter trial.N Engl J Med. 1985; 313: 1369-1375
- Aspirin dose for the prevention of cardiovascular disease: a systematic review.JAMA. 2007; 297: 2018-2024
- Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials.Lancet. 2009; 373: 1849-1860
- A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE).Lancet. 1996; 348: 1329-1339
- Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events.N Engl J Med. 2006; 354: 1706-1717
- ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery).Circulation. 2004; 110: e340-e437
- Optimal antithrombotic therapy following aortocoronary bypass: a meta-analysis.Eur J Cardiothorac Surg. 1993; 7: 169-180
- Effect of ticlopidine on saphenous vein bypass patency rates: a double-blind study.Ann Thorac Surg. 1984; 37: 371-378
- Prevention of aorta-coronary bypass graft occlusion: beneficial effect of ticlopidine on early and late patency rates of venous coronary bypass grafts: a double-blind study.J Thorac Cardiovasc Surg. 1987; 94: 773-783
- Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in Unstable angina to prevent Recurrent ischemic Events (CURE) trial.Circulation. 2004; 110: 1202-1208
- Clopidogrel and aspirin versus clopidogrel alone on graft patency after coronary artery bypass grafting.Ann Thorac Surg. 2009; 88: 59-62
- Cumulative meta-analysis of aspirin efficacy after cerebral ischaemia of arterial origin.J Neurol Neurosurg Psychiatry. 1999; 66: 255
- The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke.Lancet. 1989; 1: 1215-1220
- A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients.N Engl J Med. 1989; 321: 501-507
- Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke.N Engl J Med. 2008; 359: 1238-1251
- European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke.J Neurol Sci. 1996; 143: 1-13
- Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial.Lancet. 2006; 367: 1665-1673
- International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis.JAMA. 2006; 295: 180-189
- Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial.Lancet. 2004; 364: 331-337
- Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial.Lancet Neurol. 2007; 6: 961-969
- Preliminary evidence of a high risk of bleeding on aspirin plus clopidogrel in aspirin-naive patients in the acute phase after TIA or minor ischaemic stroke.Cerebrovasc Dis. 2010; 29: 460-467
- Aspirin for prevention of cardiovascular events in a general population screened for a low ankle brachial index: a randomized controlled trial.JAMA. 2010; 303: 841-848
- The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease.BMJ. 2008; 337: a1840
- Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.BMJ. 2002; 324: 71-86
- Systematic review of antiplatelet therapy for the prevention of myocardial infarction, stroke or vascular death in patients with peripheral vascular disease.Br J Surg. 2001; 88: 787-800
- Aspirin for the prevention of cardiovascular events in patients with peripheral artery disease: a meta-analysis of randomized trials.JAMA. 2009; 301: 1909-1919
- Antithrombotic therapy for peripheral artery occlusive disease: American College of Chest Physicians evidence-based clinical practice guidelines (8th ed.).Chest. 2008; 133: 815S-843S
- Abdominal aortic aneurysms, increasing infrarenal aortic diameter, and risk of total mortality and incident cardiovascular disease events: 10-year follow-up data from the Cardiovascular Health Study.Circulation. 2008; 117: 1010-1017
- Pathology, natural history and treatment of abdominal aortic aneurysms.Clin Res Cardiol. 2007; 96: 140-151
- Epidemiology, aetiology, risk of rupture and treatment of abdominal aortic aneurysms: does sex matter?.Eur J Vasc Endovasc Surg. 2009; 38: 278-284
- Low-dose aspirin may prevent growth and later surgical repair of medium-sized abdominal aortic aneurysms.Vasc Endovascular Surg. 2008; 42: 329-334
- Randomised trial of prophylactic daily aspirin in British male doctors.Br Med J (Clin Res Ed). 1988; 296: 313-316
- Final report on the aspirin component of the ongoing Physicians' Health Study.N Engl J Med. 1989; 321: 129-135
- Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men.N Engl J Med. 1997; 336: 973-979
- Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials.JAMA. 2006; 295: 306-313
- Aspirin is associated with reduced cardiovascular and all-cause mortality in type 2 diabetes in a primary prevention setting: the Fremantle Diabetes study.Diabetes Care. 2010; 33: 317-321
- Lack of benefits for prevention of cardiovascular disease with aspirin therapy in type 2 diabetic patients: a longitudinal observational study.Cardiovasc Diabetol. 2009; 8: 57
- Primary prevention of cardiovascular events with low-dose aspirin and vitamin E in type 2 diabetic patients: results of the Primary Prevention Project (PPP) trial.Diabetes Care. 2003; 26: 3264-3272
- Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial.JAMA. 2008; 300: 2134-2141
- Aspirin for primary prevention of cardiovascular events in people with diabetes: meta-analysis of randomised controlled trials.BMJ. 2009; 339: b4531
- Aspirin for the primary prevention of cardiovascular events: a systematic review and meta-analysis comparing patients with and without diabetes.Diabetes Care. 2009; 32: 2300-2306
- Aspirin and mortality in patients with diabetes sustaining acute coronary syndrome.Diabetes Care. 2008; 31: 363-365
- Amplified benefit of clopidogrel versus aspirin in patients with diabetes mellitus.Am J Cardiol. 2002; 90: 625-628
- Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel: Thrombolysis in Myocardial Infarction 38.Circulation. 2008; 118: 1626-1636
- A study of the beneficial effects of anticoagulant therapy in congestive heart failure.Ann Intern Med. 1952; 37: 867-887
- Dicumarol prophylaxis of thromboembolic disease in congestive heart failure.N Engl J Med. 1950; 242: 208-211
- Anticoagulation for heart failure in sinus rhythm: a Cochrane systematic review.QJM. 2002; 95: 451-459
- Dicumarol therapy in congestive heart failure.N Engl J Med. 1948; 239: 701-704
- Clinical trials update and cumulative meta-analyses from the American College of Cardiology: WATCH, SCD-HeFT, DINAMIT, CASINO, INSPIRE, STRATUS-US, RIO-Lipids and cardiac resynchronisation therapy in heart failure.Eur J Heart Fail. 2004; 6: 501-508
- The association among renal insufficiency, pharmacotherapy, and outcomes in 6,427 patients with heart failure and coronary artery disease.J Am Coll Cardiol. 2004; 44: 1587-1592
- Aspirin, beta-blocker, and angiotensin-converting enzyme inhibitor therapy in patients with end-stage renal disease and an acute myocardial infarction.J Am Coll Cardiol. 2003; 42: 201-208
- Benefits of aspirin and beta-blockade after myocardial infarction in patients with chronic kidney disease.Am Heart J. 2002; 144: 226-232
- Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients.Ann Intern Med. 2002; 137: 555-562
- Outcomes of acute coronary syndrome in a large Canadian cohort: impact of chronic renal insufficiency, cardiac interventions, and anemia.Am J Kidney Dis. 2005; 46: 845-855
- Aspirin prescription and outcomes in hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS).Am J Kidney Dis. 2007; 50: 602-611
- Cardiac medications and their association with cardiovascular events in incident dialysis patients: cause or effect?.Kidney Int. 2004; 65: 1017-1025
- Renal function and outcomes in acute coronary syndrome: impact of clopidogrel.Eur J Cardiovasc Prev Rehabil. 2007; 14: 312-318
- Clinical outcomes of patients with diabetic nephropathy randomized to clopidogrel plus aspirin versus aspirin alone (a post hoc analysis of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance [CHARISMA] trial).Am J Cardiol. 2009; 103: 1359-1363
- The efficacy and safety of short- and long-term dual antiplatelet therapy in patients with mild or moderate chronic kidney disease: results from the Clopidogrel for the Reduction of Events During Observation (CREDO) trial.Am Heart J. 2008; 155: 687-693
- Intensive oral antiplatelet therapy for reduction of ischaemic events including stent thrombosis in patients with acute coronary syndromes treated with percutaneous coronary intervention and stenting in the TRITON-TIMI 38 trial: a subanalysis of a randomised trial.Lancet. 2008; 371: 1353-1363
- Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data.Lancet. 2007; 369: 1791-1798
- Antiplatelet agents for preventing pre-eclampsia and its complications.Cochrane Database Syst Rev. 2007; 2 (CD004659)
- Low-dose aspirin for in vitro fertilization: a systematic review and meta-analysis.Hum Reprod Update. 2007; 13: 357-364
- Aspirin or anticoagulants for treating recurrent miscarriage in women without antiphospholipid syndrome.Cochrane Database Syst Rev. 2009; 1 (CD004734)
- Low-dose aspirin for in vitro fertilisation.Cochrane Database Syst Rev. 2007; 4 (CD004832)
- Evidence of absence or absence of evidence?.Fertil Steril. 2008; 90: 71-76
- Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis.Am J Obstet Gynecol. 2002; 187: 1623-1630
- Drug-eluting stent implantation for acute myocardial infarction during pregnancy with use of glycoprotein IIb/IIIa inhibitor, aspirin and clopidogrel.J Invasive Cardiol. 2008; 20: E146-E149
- Treatment of acute myocardial infarction in pregnancy with coronary artery balloon angioplasty and stenting: use of tirofiban and clopidogrel.Int J Cardiol. 2008; 127: 413-416
- Anaesthetic considerations in a parturient with critical coronary artery disease and a drug-eluting stent presenting for caesarean section.Int J Obstet Anesth. 2005; 14: 167-171
- Case report: successful pregnancy and delivery after myocardial infarction and essential thrombocythemia treated with clopidogrel.Clin Exp Obstet Gynecol. 2001; 28: 215-216
- Clopidogrel and pregnancy: a situation pregnant with danger?.Arch Gynecol Obstet. 2009; 280: 693-694
- Quantitative analysis of the main metabolites of acetylsalicylic acid.Z Geburtshilfe Perinatol. 1974; 178: 135-138
- Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin.Am J Gastroenterol. 2004; 99: 1785-1789
- Risk factors for severe delayed postpolypectomy bleeding.Endoscopy. 2008; 40: 115-119
- Aspirin does not increase bleeding complications after transbronchial biopsy.Chest. 2002; 122: 1461-1464
- Does low-dose aspirin therapy complicate oral surgical procedures?.J Am Dent Assoc. 2000; 131: 331-335
- Minor oral surgery without stopping daily low-dose aspirin therapy: a study of 51 patients.J Oral Maxillofac Surg. 2005; 63: 1262-1265
- Intraoperative and postoperative bleeding problems in patients taking warfarin, aspirin, and nonsteroidal antiinflammatory agents: a prospective study.Dermatol Surg. 1997; 23 (discussion, 384-5): 381-383
- Complications of minor cutaneous surgery in patients under anticoagulant treatment.Aesthetic Plast Surg. 2002; 26: 483-485
- Does aspirin affect the outcome of minor cutaneous surgery?.Br J Plast Surg. 1999; 52: 214-216
- Risks and benefits of anticoagulant and antiplatelet medication use before cataract surgery.Ophthalmology. 2003; 110: 1784-1788
- Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial.Lancet. 2000; 355: 1295-1302
- Low-dose aspirin for secondary cardiovascular prevention: cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation: review and meta-analysis.J Intern Med. 2005; 257: 399-414
- A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease.Eur Heart J. 2006; 27: 2667-2674
- Time and cardiac risk of surgery after bare-metal stent percutaneous coronary intervention.Anesthesiology. 2008; 109: 588-595
- Noncardiac surgery after coronary stenting: early surgery and interruption of antiplatelet therapy are associated with an increase in major adverse cardiac events.J Am Coll Cardiol. 2007; 49: 122-124
- Cardiac risk of noncardiac surgery after percutaneous coronary intervention with drug-eluting stents.Anesthesiology. 2008; 109: 596-604
- Previous coronary stent implantation and cardiac events in patients undergoing noncardiac surgery.Circ Cardiovasc Interv. 2010; 3: 236-242
- Implications of preoperative administration of aspirin in patients undergoing coronary artery bypass grafting.J Am Coll Cardiol. 1990; 15: 15-20
- The efficacy and safety of perioperative antiplatelet therapy.J Thromb Thrombolysis. 2004; 17: 21-27
- Preoperative aspirin therapy is associated with improved postoperative outcomes in patients undergoing coronary artery bypass grafting.Circulation. 2005; 112: I286-I292
- Dual antiplatelet therapy in patients requiring urgent coronary artery bypass grafting surgery: a position statement of the Canadian Cardiovascular Society.Can J Cardiol. 2009; 25: 683-689
- Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trials.Am Heart J. 2006; 152: 967-973
- Outcomes associated with combined antiplatelet and anticoagulant therapy.Chest. 2008; 133: 948-954
- Combined aspirin-oral anticoagulant therapy compared with oral anticoagulant therapy alone among patients at risk for cardiovascular disease: a meta-analysis of randomized trials.Arch Intern Med. 2007; 167: 117-124
- Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data.Lancet. 2009; 374: 1967-1974
- Incidence of hemorrhage among anticoagulated patients receiving antiplatelet therapy after percutaneous coronary intervention.J Thromb Thrombolysis. 2010; 29: 316-321
- Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome.JAMA. 2009; 301: 937-944
- Comparison of inhibitory effects of the proton pump-inhibiting drugs omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole on human cytochrome P450 activities.Drug Metab Dispos. 2004; 32: 821-827
- Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study.J Am Coll Cardiol. 2008; 51: 256-260
- Impact of proton pump inhibitors on the antiplatelet effects of clopidogrel.Thromb Haemost. 2009; 101: 714-719
- Comparison of omeprazole and pantoprazole influence on a high 150-mg clopidogrel maintenance dose: the PACA (Proton Pump Inhibitors And Clopidogrel Association) prospective randomized study.J Am Coll Cardiol. 2009; 54: 1149-1153
- Initial assessment of clinical impact of a drug interaction between clopidogrel and proton pump inhibitors.J Am Coll Cardiol. 2008; 52 (author reply, 9): 1038-1039
- Risk of rehospitalization for patients using clopidogrel with a proton pump inhibitor.Arch Intern Med. 2010; 170: 704-710
- Recurrence of acute myocardial infarction in patients discharged on clopidogrel and a proton pump inhibitor after stent placement for acute myocardial infarction.Clin Cardiol. 2010; 33: 168-171
- Relation of proton pump inhibitor use after percutaneous coronary intervention with drug-eluting stents to outcomes.Am J Cardiol. 2010; 105: 833-838
- A population-based study of the drug interaction between proton pump inhibitors and clopidogrel.CMAJ. 2009; 180: 713-718
- Cardiovascular outcomes and mortality in patients using clopidogrel with proton pump inhibitors after percutaneous coronary intervention or acute coronary syndrome.Circulation. 2009; 120: 2322-2329
- Meta-analysis: the effects of proton pump inhibitors on cardiovascular events and mortality in patients receiving clopidogrel.Aliment Pharmacol Ther. 2010; 31: 810-823
- Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study.Ann Intern Med. 2010; 152: 337-345
- The impact of treatment with omeprazole on the effectiveness of clopidogrel drug therapy during the first year after successful coronary stenting.Can J Cardiol. 2010; 26: e54-e57
- Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials.Lancet. 2009; 374: 989-997
- Clopidogrel with or without omeprazole in coronary artery disease.N Engl J Med. 2010; 363: 1909-1917
- ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use.J Am Coll Cardiol. 2010; 56: 2051-2066
- Cyclooxygenase inhibitors and the antiplatelet effects of aspirin.N Engl J Med. 2001; 345: 1809-1817
- Pharmacodynamic interaction of naproxen with low-dose aspirin in healthy subjects.J Am Coll Cardiol. 2005; 45: 1295-1301
- A new cyclooxygenase-2 inhibitor, rofecoxib (VIOXX), did not alter the antiplatelet effects of low-dose aspirin in healthy volunteers.J Clin Pharmacol. 2000; 40: 1509-1515
- Lumiracoxib does not affect the ex vivo antiplatelet aggregation activity of low-dose aspirin in healthy subjects.J Clin Pharmacol. 2005; 45: 1172-1178
- The COX-2 selective inhibitor, valdecoxib, does not impair platelet function in the elderly: results of a randomized controlled trial.J Clin Pharmacol. 2003; 43: 504-513
- Celecoxib, ibuprofen, and the antiplatelet effect of aspirin in patients with osteoarthritis and ischemic heart disease.Clin Pharmacol Ther. 2006; 80: 264-274
- Effect of ibuprofen on cardioprotective effect of aspirin.Lancet. 2003; 361: 573-574
- Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal antiinflammatory drugs.Circulation. 2003; 108: 1191-1195
- Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial.Lancet. 2004; 364: 675-684
- Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis?.BMJ. 2006; 332: 1302-1308
- Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2.JAMA. 2006; 296: 1633-1644
- Differential effects of aspirin and non-aspirin nonsteroidal antiinflammatory drugs in the primary prevention of myocardial infarction in postmenopausal women.Epidemiology. 2000; 11: 382-387
- Non-steroidal anti-inflammatory drugs and risk of serious coronary heart disease: an observational cohort study.Lancet. 2002; 359: 118-123
- Nonsteroidal antiinflammatory drugs and the risk of myocardial infarction in the general population.Circulation. 2004; 109: 3000-3006
- Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis.N Engl J Med. 2000; 343 (2 pp following 1528): 1520-1528
- Association between naproxen use and protection against acute myocardial infarction.Arch Intern Med. 2002; 162: 1111-1115
The full paper corresponding to this Executive Summary will be published as a supplement to the Canadian Journal of Cardiology May/June issue.
This statement was developed following a thorough consideration of medical literature and the best available evidence and clinical experience. It represents the consensus of a Canadian panel comprised of multidisciplinary experts on this topic with a mandate to formulate disease-specific recommendations. These recommendations are aimed to provide a reasonable and practical approach to care for specialists and allied health professionals obliged with the duty of bestowing optimal care to patients and families, and can be subject to change as scientific knowledge and technology advance and as practice patterns evolve. The statement is not intended to be a substitute for physicians using their individual judgment in managing clinical care in consultation with the patient, with appropriate regard to all the individual circumstances of the patient, diagnostic and treatment options available and available resources. Adherence to these recommendations will not necessarily produce successful outcomes in every case.