Increased Atherothrombotic Burden in Patients with Diabetes Mellitus and Acute Coronary Syndrome: A Review of Antiplatelet Therapy

Table 3

Outcomes from large-scale randomised placebo-controlled trials evaluating the efficacy of dual antiplatelet therapy with aspirin and clopidogrel versus aspirin alone in ACS/PCI patients in the overall study population and in DM patients.

Study	Scenario	Primary end point	n (overall)	% of events and association measure (overall)	n (DM)	% of events and association measure (DM)
CURE [22]	UA/NSTEMI	Cardiovascular death, nonfatal MI, or stroke at 1 year	12 562	9.3 versus 11.4	2840	14.2 versus 16.7
RR (95% CI)				0.80 (0.72–0.90)		0.84 (0.70–1.02)
PCI-CURE [159]	CURE patients undergoing PCI	Cardiovascular death, MI, or urgent TVR at 30 days	2658	4.5 versus 6.4	504	12.9 versus 16.5
RR (95% CI)				0.70 (0.50–0.97)		0.77 (0.48–1.22)
		Death, MI, or stroke at
CREDO [158]	Elective PCI	1 year	2116	8.5 versus 11.5	560	NR
RRR (95% CI), %				26.9 (3.9–44.4)		11.2 (−46.8–46.2)
COMMIT [157]	Acute MI (93% STEMI)	Death, reinfarction or stroke at discharge or 28 days	45 852	9.2 versus 10.1	NR	NR
OR (95% CI)				0.91 (0.86–0.97)
CLARITY [156]	STEMI with fibrinolysis	Occluded infarct-related artery on angiography or death or recurrent MI before angiography	3491	15.0 versus 21.7	575	NR
OR (95% CI)				0.64 (0.53–0.76)
PCI-CLARITY [155]	CLARITY patients undergoing PCI	Cardiovascular death, recurrent MI or stroke at 30 days	1863	3.6 versus 6.2	282	6.0 versus 10.1
OR (95% CI)				0.54 (0.35–0.85)		0.61 (0.24–1.53)

CURE: Clopidogrel in Unstable angina to Prevent Recurrent Events; CREDO: Clopidogrel for Reduction of Events During Observation; COMMIT: Clopidogrel and Metoprolol in Myocardial Infarction Trial; CLARITY: Clopidogrel as Adjunctive Reperfusion Therapy; UA: Unstable Angina; TVR: Target Vessel Revascularisation; RR: Relative Risk; RRR: Relative Risk Reduction; OR: Odds Ratio; NR: Not Reported. Adapted from [74].