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  4. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee.
 
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Titre

A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee.

Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
The Lancet  
Auteur(s)
Gent, M.
Auteure/Auteur
Contributrices/contributeurs
Beaumont, D.
Blanchard, J.
Bousser, M.G.
Coffman, J.
Easton, J.D.
Hampton, J.R.
Harker, L.A.
Janzon, L.
Kusmierek, J.J.
Panak, E.
Roberts, R.S.
Shannon, J.S.
Sicurella, J.
Tognoni, G.
Tool, E.J.
Verstraete, M.
Warlow, C.
Verstraete, M.
Easton, J.D.
Bousser, M.G.
Cairns, J.A.
Chesebro, J.H.
Hampton, J.R.
von der Lippe, G.
Ross Russell, R.W.
Wolf, P.A.
Boissel, J.P.
Friedman, L.
Fuster, V.
Harrison, M.G.
Pocock, S.
Weksler, B.B.
Gent, M.
Foster, G.
Lewis, G.
Lychak, T.
Nelson, H.L.
Roberts, R.S.
Sicurella, J.
Sicurella, J.
Stewart, C.
Szechtman, B.
Chrolavicius, S.
Copland, I.
Jedrzojawski, B.
McCreadie, F.
Wilkinson, L.
Vonderveehn, S.
Boissel, J.P.
Boutitie, F.
Beaumont, D.
Perdriset, G.
Thizon de Gualle, I.
Hoek, J.
Besnier, M.O.
Boddy, A.
Brooker, D.
Derzko, G.
Jones, A.
Metzinger, C.
Novack, J.
Pratt, S.
Roome, D.
Schulhof, J.P.
Vallee, E.
Valtier, D.
Bastida, E.
Coy, L.
Creek, R.
Destelle, G.
Döberl, T.
de la Forest-Divonne, N.
Gallo, G.
Garcia, A.
Geudelin, B.
Hundt, F.
Hylkema, R.
Vanhove, P.
Amalfitano, N.
Cabala, K.
Caniglia, J.
Duval, I.
Forgie, L.
Neiss, A.C.
Wesseling, T.
Plehn, J.F.
Kennedy, S.J.
Zwolak, R.M.
Reeves, A.
McDaniel, M.D.
MacDonald, G.J.
Murphy, C.
Howes, P.S.
Cornell, L.K.
Hynes, M.L.
Jackson, C.M.
Lyden, P.D.
Rothrock, J.F.
Hye, R.J.
Dittrich, H.C.
Kelly, N.M.
Kerridge, C.M.
Chippendale, T.
Lobatz, M.
Diamond, E.
Schim, J.
Sadoff, M.
Logan, W.
Auer, A.
Hamilton, W.
Frere, R.
Schroer, S.
Wilcox, M.
Naeger, C.
Harbison, J.W.
Makhoul, R.
Taylor, J.R.
Felton, W.L.
Lee, H.M.
Massey-Makhoul, K.
Browne, K.F.
Tyson, G.S.
Pineiro, E.
Brenner, A.S.
Ford, R.A.
Reddy, P.J.
Owens, P.
Heinsimer, J.
Richter, K.
Markowski, K.
Lentini, T.
Howell, L.
Colfer, H.T.
Rynbrandt, D.J.
Wendt, C.D.
Wilmot, M.
Stone, B.
Touchon, R.
Briley, D.
Adkins, L.
Roe, K.
Harless, C.
DeWood, M.A.
Skidmore, J.A.
Randall, J.M.
Davenport, J.
Farmer, C.
Hanson, S.
Kuo, L.C.
Brown, P.
DesJardins, J.
Halpern, N.
Talbot, W.
Schainfeld, R.
Rosenfield, K.
Isber, J.M.
Grall, E.
Lanza, S.
Walker, P.A.
Ivanhoe, R.J.
Milunski, M.R.
Kereiakes, D.J.
Abbottsmith, C.W.
Lausten, D.A.
Helgason, C.M.
Glover, V.
Gnutek, T.
Clark, W.M.
Coull, B.M.
Harrison, E.
Suh, J.T.
McBride, J.W.
Foster, B.
Vittum, K.
Lauer, N.Y.
Adornato, B.T.
Adornato, M.K.
Fisher, M.
Ameriso, S.F.
Scicli, A.
Starling, M.R.
Petrusha, J.A.
Devlin, W.H.
Suter, C.C.
Tucci, J.
Stewart, S.H.
Sadowsky, C.
Stone, R.
Tuchman, M.
Massin, E.K.
Anderson, H.V.
Harlan, M.
Abrams, J.
Timm, C.
Rosenberg, G.
Hiatt, W.R.
Regensteiner, J.G.
Bauer, T.
Frey, J.L.
Darbonne, C.
Marlor, L.
Haire, W.D.
Stephens, L.C.
Kotulak, G.D.
Iteld, B.
VanderStappen, A.
Neuman, V.
Kleiman, N.
Bushman, L.
Fischer, A.
Clark, W.M.
Harrison, E.
Moon, H.
Klassen, A.C.
Berman, M.E.
Sufit, R.
Biller, J.
Olin, J.W.
Pirzada, C.A.
Medical, V.A.
Hershey, L.A.
Burch, K.
Castaldo, J.
Jenny, D.
Wohlberg, C.
Gaines, K.
Cape, C.
Gupta, S.K.
Landa, R.A.
Norcross, S.R.
Culebras, A.
Pastor, D.C.
Fairman, R.M.
Zakulec, S.
Sutton, J.M.
McCullough, T.
Fenster, P.E.
Feinberg, W.M.
Pellegrino, R.G.
Jeffers, C.
Smith, W.B.
Vargas, R.
McCormick, T.
Ramadan, N.M.
Levine, S.R.
Hirsch, A.T.
Wasserman, A.G.
Nys, A.
Breslin, D.J.
Labib, S.B.
Woodhead, G.
Matzura, T.M.
Dunlap, S.
Goodman, M.A.
Cappelli, J.
Stein, P.
Nadamanee, K.
Havranek, E.
Weinberger, J.
Lava, N.S.
Horowitz, S.
Byer, J.
Wentworth, D.
Dexter, J.D.
Bonnett, A.
Vetrovec, G.W.
O'Brien, R.P.
Easton, J.D.
Wilterdink, J.L.
Gelber, D.A.
Hemberger, S.
Sherman, D.
Rogers, D.
Alberts, M.J.
McClenny, C.
Weeks, K.D.
Whisnant, D.
D'Alton, J.
Doolittle, H.
Siller, K.A.
Hass, W.K.
Grines, C.
Timmis, G.
Gorelick, P.B.
Robinson, D.
Lumsden, A.B.
MacDonald, J.
Hughes, R.L.
Noonan, V.
Goldberg, G.
Costello, R.
Mohiuddin, S.
Stengel, L.
Frankel, M.R.
Braimah, J.
Creager, M.A.
Baum, P.
Cooke, J.P.
Ma, A.
Babikian, V.L.
O'Neal, M.A.
Mirsen, T.
Bruegel, C.
Coffman, J.D.
Brindley, D.C.
Mick, M.
Korenman, S.G.
Brass, L.M.
Asher, S.W.
Halperin, J.L.
Schlesinger, R.
Gacioch, G.M.
Couch, J.R.
Skolnick, B.E.
Ware, M.S.
Anderson, J.
Knepper, L.
Victor, M.
Ball, S.
Gurley, J.C.
Jessup, M.
Elkayam, U.
Hughes, W.G.
Fraser, J.A.
Potvin, E.A.
McMillan, J.
Grierson, J.
Hartwick, N.
Musclow, S.
Thompson, A.
Mewett, J.
Sivan, R.
Turpie, A.G.
Morino, S.
Siguenza, M.
Blakely, J.A.
Styling, S.
Balleza, L.
Beanlands, D.S.
Garrard, L.
Morgan, K.
Ruddy, T.
Morris, A.L.
Anderson, B.A.
Arneja, A.S.
Carter, S.A.
Daniels, V.
McEwen, B.
Ricci, A.J.
Swan, J.H.
Goode, J.E.
Selby, D.A.
Bozek, B.
Shuaib, A.
Yeung, M.
Press, M.
Walston, L.L.
Fung, A.Y.
Henning, H.
Taylor, D.C.
Abbey, H.
Davies, C.
Saunders, L.
Tanser, P.H.
Feldman, D.
Sullivan, B.
Sayles, M.J.
Kent, E.
Connolly, S.J.
Coletta, E.
Carruthers, V.
Hui, W.
Klinke, P.
Brass, N.
Kvill, L.
Cusson, J.
Van Nguyen, P.
Marchand, L.
Roy, S.
Blair, J.F.
Wellington, J.L.
Rody, K.
Poloni, S.
Myers, M.G.
Morgan, C.D.
Parsons, P.
Lecours, R.
Patanaude, J.V.
Turcotte, C.
Gutelius, J.R.
Pattenden, R.
Gagnon, R.M.
Racine, N.
Roy, C.
Harris, K.
Lovell, M.
Teal, P.A.
Bloomer, J.L.
Thompson, C.R.
Wong, M.
Sladen, J.G.
MacDonald, K.
Heinrich, D.
Houde, G.
Nadeau, C.
Talbot, P.
Pagé, A.
Verdant, A.
Smilovitch, M.
Racine, N.
Steinmetz, O.
Simard, D.
Benguigui, C.
Ouellet, C.
LeBrun, L.H.
Desrochers, M.P.
Finnie, K.
McCreery, S.
Kostuk, W.J.
Pflugfelder, P.W.
Oskalns, R.
Bonet, J.F.
Ilott, K.
McConnell, J.
Ruel, M.
Primeau, L.
Phillips, S.
Coleman-Kamphuis, L.
Leclerc, J.R.
Solymoss, S.
Côté, R.
Bourque, F.
Lee, T.K.
Kvill, L.
Bernstein, V.
Doyle, L.
Timothee, J.R.
Chebayeb, R.
Lefkowitz, C.
Hambly, P.
Klein, G.M.
Robertson, M.
Bayer, N.
Couse, P.
Norris, J.W.
Medel, M.J.
Sevitt, B.
Fitzsimons, J.
Fitchett, D.
Serpa, A.
Marr, D.
Ouellet, B.
Bellavance, A.
Pryse-Phillips, W.
Howse, D.C.
Rabkin, S.W.
McCans, J.
Brandjes, D.P.
Büller, H.R.
Dÿkema, A.R.
Kromhout, J.G.
Lawson, J.A.
Peters, R.J.
van der Sande, J.J.
Stam, J.
Blok, L.M.
Jenner, Y.
Ternede, O.
Lens, J.
Bollen, E.C.
Welten, R.J.
Termeulen, P.
Hollanders, W.P.
Lok, D.J.
Groeneveld, H.
Bouwens, L.H.
Tietge, F.C.
van der Velden, E.C.
Bruggink-André, P.W.
van Iersel, G.J.
Seegers, J.
van Vliet, A.C.
van der Sar, P.
Verhoog, B.D.
van der Sar de Nooijer, S.H.
Verhoog-Nijhuis, I.
Franke, C.L.
Koehler, P.J.
van der Meer, J.
van Os, J.S.
van der Heijden, M.
van Wijk, L.M.
Kragten, J.A.
de Warrimont-Henquet, J.
Feld, R.
Van Gemert, H.M.
Dippel, D.W.
Koudstaal, P.J.
Vanneste, J.A.
Linssen, W.H.
Kruisdijk, J.J.
Visser, J.
Van Gool, T.F.
Vooges, J.
De Vries, A.C.
Klinkert, P.
Bartlema, K.A.
Banga, J.D.
Niemeijer-Kanters, S.D.
de Groot, M.G.
Moll, F.L.
Sybrandy, R.
Buth, J.
Schol, F.P.
Donders, R.C.
Algra, A.
Pop, G.A.
van der Heijden, R.
Knippenberg, B.
Sier, J.C.
Berqvist, D.
Karacagil, S.
Eriksson, I.
Bowald, S.
Holmberg, A.
Ljungman, C.
Westman, B.
Sivenius, J.
Puranen, J.
Karinen, A.
Onatsu, J.
Salmenperä, T.
Kalinen, M.
Kaste, M.
Tatlisumak, T.
Soinne, L.
Kallela, M.
Kotila, M.
Hartford, M.
Herlitz, J.
Karlson, B.W.
Strömblad, S.O.
Olofsson, B.O.
Strand, T.
Kristensen, B.
Malm, J.
Melin, J.H.
Virtanen, M.
Olli, T.
Lindgärde, F.
Pessah-Rasmussen, H.
Rendell, M.
Ericsson, U.B.
Sahlman, A.
Savolainen, H.
Rämö, J.
Lehtonen, J.
Hillbom, M.E.
Reunanen, M.
Turkka, J.
Ylönen, K.
Peltola, T.
Juvonen, T.
Koskela, E.
Erkinheimo, J.
Ängquist, K.A.
Hedberg, B.
Arnerlov, C.
Rissanon, A.
Murros, K.
Idänpään-Heikkilä, U.
Honka, L.
Heikkilä, J.
Tiensuu, T.
Boberg, J.
Berggren, A.L.
Thompson, P.L.
Yu, E.T.
Bradshaw, P.J.
Cooke, P.A.
Gordon, S.P.
Loh, K.S.
McQuillan, B.
Moshiri, M.M.
Cross, D.B.
Egerton, W.S.
Walker, P.J.
Codd, C.A.
Kreuter, D.A.
Cox, S.
Naik, D.
Cavaye, D.M.
Harel, M.C.
Horowitz, J.
Rowe, C.
Stewart, S.
Boundy, K.
Stringer, C.F.
Anderson, J.L.
Coller, D.
Aylward, P.
Anderson, C.
Burns, R.
Schultz, D.
Waddy, P.
Walsh, J.
Davies, L.
Harris, J.P.
Wetzlar, A.
McDougall, A.
Sieunarine, K.
Cremer, P.
Donnan, G.A.
Tonkin, A.
Levi, C.
Hanlan, J.
Ellery, F.
White, H.D.
Hamer, A.W.
Kapadia, V.
Ramanathan, K.
Taylor, R.R.
Hankey, G.
Brooks, M.
Young, T.
McInerney, M.
Sansom, J.
Thomson, R.
Spaulding, C.
Cutforth, R.
Thomson, A.
Salem, H.H.
Coughlin, P.
Campbell, T.J.
Lord, R.S.
O'Sullivan, D.
Corrigan, C.
D'Arcy, S.
Anderson, N.E.
Charleston, A.J.
Davis, S.M.
Gerraty, R.
Bett, N.
Hewson, D.J.
Kester, R.C.
Scott, D.J.
Berridge, D.C.
Kent, P.J.
Thornton, C.A.
Sykes, H.
Bennett, S.
Blakey, D.
Brooksby, W.P.
Johnston, R.T.
Brack, M.
Hampton, J.R.
Vowden, P.
Gough, M.J.
Hooper, R.
Gough, M.
Hanley, S.P.
MacAskill, M.
Miles, J.
Waywell, C.
Mucklow, J.C.
Davis, C.
Harper, P.
Cooke, K.
Lowe, G.
Shaw, B.
McKillop, J.
Dormandy, J.A.
Chaudhry, H.
Evans, J.
Bamford, J.M.
Blundell, S.
Venables, G.
Doyle, C.
Shearman, C.P.
Crow, A.
Dennis, M.
Sandercock, P.
Brown, M.M.
Rogers, J.
Boyle, R.M.
Wiseman, B.S.
Humphrey, P.R.
Prentice, C.R.
Moccetti, T.
Pasotti, E.
Sessa, F.
Bertolini, A.
Rossi, A.
Del, A.
Malacrida, R.
Moccetti, D.
Besomi, G.
Mattle, H.P.
Eicher Vella, E.
Maurer, D.
Rihs, F.
Hoffmann, U.
Bollinger, A.
Franzeck, U.K.
Mahler, F.
Do, D.
Baumgartner, I.
Weder, B.
Bönig, L.
Ludin, H.P.
Bogousslavsky, J.
Maeder-Ingvar, M.
Regli, F.
Kappenberger, L.
Depairon, M.
Bizzini, G.
Beretta-Piccoli, C.
Elshater-Zanetti, F.
Guffi, C.
Bertel, O.
Deseö, T.
Gmuer, W.
Bounameaux, H.
Wicky, J.
Desmarais, S.
Vogt, P.
Fellay, D.
Rhyner, K.
Wojtyna, W.
Bonetti, T.
Brunner, J.
Jäger, K.A.
von Planta, I.
Noseda, G.
Pugliesi, A.
Pons-Giudici, L.
Meier, B.
Evéquoz, D.
Schmidt, D.
Keel, H.S.
Heinrich, D.
Follath, F.
Brunner, H.P.
Caduff, B.
Wirth, M.
Vuilliomenet, A.
Savcic, M.
Hürlimann, U.
Bosshard, E.
Hacke, W.
Brandt, T.
Wildermuth, S.
Ringleb, P.
Busse, O.
Straeten, V.
Zeuner, K.
Vielhaber, S.
Tettenborn, B.
Krämer, G.
Allardt, A.
Schmitt-Henco, E.
Diener, H.C.
Schrader, V.
Nebe, J.
Pilger, E.
Doder, A.
Gürtl, B.
Diehm, C.
Gomer, M.
Jansen, T.
Kömpf, D.
Kaps, M.
Vidal-Langwasser, M.
Hennerici, M.
Daffertshofer, M.
Schminke, U.
Osterhues, H.H.
Fischer, A.
Rupprecht, H.J.
Borkowski, U.
Rudofsky, G.
Rescher, A.
Schwerdt, H.
Hammer, B.
Voss, R.
Grebe, M.
Rieger, H.
Grobe, R.
Theiss, W.
Schaub, F.
Neumann, F.J.
Lutilsky, L.
Aichner, F.T.
Schmidauer, C.
Erdlenbruch, K.
Mórsdorf, B.S.
Hornig, C.R.
Moulin, T.
Chavot, D.
Autret, A.
Lucas, C.
Leys, D.
Henon, H.
Chedru, F.
Ameri, A.
Dunand, J.F.
Dambrine, P.
Gabriel, A.
Labaki, F.
Tran-Tranh, X.
Jouannon, C.
Durup, F.
Pagès, M.
Blard, J.M.
Giroud, M.
Menassa, M.
Zuber, M.
Mas, J.L.
Hommel, M.
Besson, G.
Laurian, C.
Mathieu, J.F.
Geraud, G.
Larrue, V.
Ben-Hamda, K.
Fumey, R.
Guiraud-Chaumeil, B.
Chollet, F.
Pathé, M.
Zannier-Marzari, D.
Chabriat, H.
Amarenco, P.
Pinel, J.F.
Beaune, J.
Pichard, J.B.
Medvedowsky, A.
Becker, F.
Terriat, B.
Woimant, F.
Cathelineau, G.
Martin Jadraque, I.
López Sendon, J.L.
Gonzales Maqueda, I.
Roldan Rabadan, I.
Cruz Fernández, J.M.
López Garcia, V.
Ros Die, E.
Gonzáles Rios, J.
Del Foco, O.
Chamorro, A.
Alday, M.
Matias-Guiu, J.
Gracia, F.
Pomar Moya-Prats, J.L.
Mestres, C.A.
Jiménez Cossio, J.A.
Riera de Cubas, L.
Barreiro Tella, P.
Diez Tejedor, E.
Cunha, L.
Goncalves, A.F.
Ferro, M.A.
Barbosa, V.
Santiago, D.
Ferro, J.M.
Melo, T.P.
Oliveira, V.
Pinto, A.N.
Bordalo-Sá, A.L.
Ferreira, D.
Tuna, J.L.
Providência, L.
Morais, J.
Pimenta, A.
Van de Werf, F.
Luyten, A.
Luys, C.
Blecic, S.A.
Van Blercom, N.G.
Hildebrand, J.G.
Sadzot, B.
Franck, G.
Brohet, C.
Huyberechts, D.
Zicot, M.
Petermans, J.
Duprez, D.A.
Clement, D.L.
Verhaeghe, R.
Peerlinck, K.
De Reuck, J.
Bosschaerts, T.
Wautrecht, J.C.
Coccheri, S.
Fortunato, G.
Catalano, M.
Libretti, A.
Carolei, A.
Mearelli, S.
Gresele, P.
Selli, L.
Nenci, G.G.
Morini, M.
Cortellaro, M.
Chierchia, S.L.
Luca Messa, G.
Groupes de travail
CAPRIE Steering Committee
Liens vers les personnes
Depairon Réveilhac, Michèle  
Liens vers les unités
Hypertension et médecine vasculaire  
ISSN
0140-6736
Statut éditorial
Publié
Date de publication
1996-11-16
Volume
348
Numéro
9038
Première page
1329
Dernière page/numéro d’article
1339
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Many clinical trials have evaluated the benefit of long-term use of antiplatelet drugs in reducing the risk of clinical thrombotic events. Aspirin and ticlopidine have been shown to be effective, but both have potentially serious adverse effects. Clopidogrel, a new thienopyridine derivative similar to ticlopidine, is an inhibitor of platelet aggregation induced by adenosine diphosphate.
CAPRIE was a randomised, blinded, international trial designed to assess the relative efficacy of clopidogrel (75 mg once daily) and aspirin (325 mg once daily) in reducing the risk of a composite outcome cluster of ischaemic stroke, myocardial infarction, or vascular death; their relative safety was also assessed. The population studied comprised subgroups of patients with atherosclerotic vascular disease manifested as either recent ischaemic stroke, recent myocardial infarction, or symptomatic peripheral arterial disease. Patients were followed for 1 to 3 years.
19,185 patients, with more than 6300 in each of the clinical subgroups, were recruited over 3 years, with a mean follow-up of 1.91 years. There were 1960 first events included in the outcome cluster on which an intention-to-treat analysis showed that patients treated with clopidogrel had an annual 5.32% risk of ischaemic stroke, myocardial infarction, or vascular death compared with 5.83% with aspirin. These rates reflect a statistically significant (p = 0.043) relative-risk reduction of 8.7% in favour of clopidogrel (95% Cl 0.3-16.5). Corresponding on-treatment analysis yielded a relative-risk reduction of 9.4%. There were no major differences in terms of safety. Reported adverse experiences in the clopidogrel and aspirin groups judged to be severe included rash (0.26% vs 0.10%), diarrhoea (0.23% vs 0.11%), upper gastrointestinal discomfort (0.97% vs 1.22%), intracranial haemorrhage (0.33% vs 0.47%), and gastrointestinal haemorrhage (0.52% vs 0.72%), respectively. There were ten (0.10%) patients in the clopidogrel group with significant reductions in neutrophils (< 1.2 x 10(9)/L) and 16 (0.17%) in the aspirin group.
Long-term administration of clopidogrel to patients with atherosclerotic vascular disease is more effective than aspirin in reducing the combined risk of ischaemic stroke, myocardial infarction, or vascular death. The overall safety profile of clopidogrel is at least as good as that of medium-dose aspirin.
Sujets

Adult

Arteriosclerosis/prev...

Aspirin/administratio...

Aspirin/adverse effec...

Aspirin/therapeutic u...

Brain Ischemia/preven...

Clopidogrel

Cohort Studies

Double-Blind Method

Female

Follow-Up Studies

Hemorrhage/chemically...

Humans

Male

Myocardial Ischemia/p...

Peripheral Vascular D...

Platelet Aggregation ...

Platelet Aggregation ...

Platelet Aggregation ...

Ticlopidine/administr...

Ticlopidine/adverse e...

Ticlopidine/analogs &...

Ticlopidine/therapeut...

Treatment Outcome

PID Serval
serval:BIB_9BB868942EFA
DOI
10.1016/s0140-6736(96)09457-3
PMID
8918275
WOS
A1996VT33200008
Permalien
https://iris.unil.ch/handle/iris/145966
Date de création
2008-02-28T10:59:18.190Z
Date de création dans IRIS
2025-05-20T22:07:49Z
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