Coronary disease & ACSMeta-analysis
Aspirin vs clopidogrel in chronic coronary syndromes: a meta-analysis of ethnic differences
- Systematic review and meta-analysis of randomised trials
- prespecified subgroup interaction by ethnicity
- trial sequential analysis
Authors' 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 patients · 7 randomized controlled trials (RCTs)
- Comparison
- Clopidogrel vs aspirin for secondary prevention
- Outcome
- Trial-defined MACE
- Follow-up
- Median 36.0 months
Pooled result
MACE
Incidence rate ratio
0.83
95% CI 0.69–0.99
Clopidogrel vs 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
Summarised from the published abstract; every number is checked against it