Aspirin vs clopidogrel in chronic coronary syndromes: a meta-analysis of ethnic differences
Pooled result · MACEResult — go to the resultIncidence rate ratio 0.83 95% CI 0.69–0.99Authors' conclusion
In patients with CCS, the overall body of evidence suggests improved outcomes with clopidogrel compared with aspirin, without an apparent effect on mortality.
Study context
- Population
- Patients with chronic coronary syndromes (CCS)
- Participants
- 30,165 patients7 randomized controlled trials (RCTs)
- Comparison
- Clopidogrel vs aspirin for secondary prevention
- Outcome
- Trial-defined MACE
- Follow-up
- Median 36.0 months
Methodological detailsprespecified subgroup interaction by ethnicity, trial sequential analysis
- Prespecified subgroup interaction by ethnicity
- Trial sequential analysis
Pooled result
MACE
Incidence rate ratio
0.83
95% CI 0.69–0.99
Clopidogrelvs Aspirin
IRR 0.83 (95% CI 0.69–0.99)
As reported in the abstract
Further pooled results
Major adverse cardiovascular events (MACE) by ethnicity (prespecified subgroup)
- East Asians: IRR
- 0.76 (95% CI 0.59-0.98)
- Non-East Asians: IRR
- 1.00 (95% CI 0.74-1.36)
- No significant benefits in non-East Asian patients
- Interaction P = 0.010
Mortality by ethnicity (subgroup)
- Significant interaction by ethnicity
- Pint = 0.014
Major bleeding, MI, mortality
- No differences between groups
Safety
Major bleeding
- No difference between groups
Original publication
Aspirin vs clopidogrel in chronic coronary syndromes: a meta-analysis of ethnic differences. Eur Heart J. Published 19 May 2026. doi:10. 1093/ eurheartj/ ehag351
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