CURRENT OASIS 7 trial

CURRENT OASIS 7 trial

CURRENT OASIS 7 trial [Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. N Engl J Med 2010;363:930-42] randomized over twenty five thousand patients with acute coronary syndrome (more than two thirds unstable angina / non ST segment elevation myocardial infarction and less than one third of ST elevation myocardial infarction), who were referred for an invasive treatment strategy. One arm received 600 mg loading dose of clopidogrel followed by a maintenance dose of 150 mg daily for 6 days and 75 mg daily thereafter. Second arm received 300 mg clopidogrel loading dose and 75 mg daily maintenance dose. There was another independent randomization for high dose vs low dose aspirin (300 to 325 mg vs 75 to 100 mg daily). Hence this was a 2×2 factorial randomized trial. The primary outcome was cardiovascular death, myocardial infarction, or stroke at 30 days. The trial concluded that there was no significant difference in the primary outcome in any of the groups. But, double dose clopidogrel was associated with a significant reduction in stent thrombosis in the seventeen thousand odd patients who underwent percutaneous coronary intervention (1.6% vs 2.3%; P=0.001). Stent thrombosis was defined as a secondary outcome in this trial.