+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 2 CK (https://www.usmleforum.com/forumdisplay.php?fid=3)
+--- Thread: q3 - showman (/showthread.php?tid=364421)
q3 - showman - ArchivalUser - 11-28-2008
5. All of the following are true of dual-antiplatelet therapy
with aspirin and clopidogrel except:
a) It lowers the risk of stent thrombosis and adverse
cardiac events in patients who have undergone
percutaneous coronary intervention.
b) It is more effective than aspirin alone at lowering
the risk of atherothrombotic events in patients
with stable cardiovascular disease or multiple risk
factorsc) It is associated with an increased risk of bleeding
in the elderly (age gt 75 years) with acute coronary
syndromes.
d) It may both safely and effectively reduce mortality
and the occurrence of major adverse vascular
events in patients presenting with acute MI.
e) Desensitization for clopidogrel-sensitive patients
appears safe and highly effective in inducing a
sustained remission for patients who require prolonged
therapy after drug-eluting stents.
0 - ArchivalUser - 11-28-2008
ddd?
0 - ArchivalUser - 11-28-2008
: B
Dual antiplatelet therapy has been shown to reduce
stent thrombosis and adverse cardiac events. Several studies
on suspected acute MI (left bundle branch block, STsegment
elevation, or ST-segment depression) have found
a significant reduction in the risk of reinfarction, stroke,
and death in patients presenting with an acute MI with
aspirin plus clopidogrel (9.2%) compared to the group
given aspirin plus placebo (10.1%; 9% proportional risk
reduction, 95% confidence interval [CI] 3%-14%, P =
.002, data from the COMMIT study). All-cause mortality
was also significantly lower in the aspirin-clopidogrel
group than in the aspirin-placebo group (7.5% vs 8.1%;
7% proportional risk reduction, 95% CI 1%-13%, P =
.03). Desensitization appears safe and highly effective in
inducing a sustained remission in clopidogrel-sensitive
patients who require prolonged dual antiplatelet therapy
after placement of a drug-eluting stent. However, the
CHARISMA study, which randomized more than 15,000
patients (≥ 45 years) with clinical cardiovascular disease
or multiple cardiac risk factors to either aspirin plus
placebo or aspirin plus clopidogrel, showed that clopidogrel
added no significant benefit in preventing
atherothrombotic events in patients with stable cardiovascular
disease or multiple risk factors.
0 - ArchivalUser - 11-28-2008
Thanks Showman.