Clopidogrel gender differences not statistically significant

A meta-analysis of the major clopidogrel trials suggests that the drug reduces cardiovascular events and increases bleeding in both men and women, with no significant differences in treatment effect between the sexes. The meta-analysis included almost 80,000 patients participating in the CURE, CREDO, CLARITY TIMI 28, COMMIT, and CHARISMA trials. Results showed that in the overall population, clopidogrel was associated with a highly significant 14% proportional reduction in the risk of cardiovascular events (cardiovascular death, MI, or stroke). Women showed a non-significantly lower risk of cardiovascular events while on clopidogrel compared with placebo (11% versus 11.8%, OR 0.93) whereas men had a highly significant reduction in cardiovascular event risk with clopidogrel compared with placebo (7.8% versus 9%, OR 0.84). Women appeared to get a benefit with clopidogrel primarily in reduction of MI risk (OR 0.81), whereas the effects on stroke (OR 0.91) and all-cause mortality (OR 0.99) were not statistically significant.Among men the risk reduction was significant for MI, stroke, and death. Bleeding was increased in both sexes and was non-significantly greater in women (43% vs 22%). “Despite these observations, there was no evidence of statistically significant heterogeneity when the effect of clopidogrel was compared between women and men, indicating that much of the difference between men and women could be explained by play of chance,” the study authors wrote in JACC. “The results of this analysis are reassuring and thus differ from the results seem with aspirin and glycoprotein IIb/IIIa agents,” David Faxon from Brigham and Women's Hospital in Boston said in an accompanying editorial....