Presented by Dr TONG Chun Wai at the daily Journal Club of ICU, PYNEH, Hong Kong, on 19 May 2009
In the article "The ACTIVE Investigators. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. NEJM 2009: 360: 2066 – 78", it was found that in patients with atrial fibrillation for whom vitamin K–antagonist therapy was unsuitable, the addition of clopidogrel to aspirin reduced the risk of major vascular events, especially stroke, and increased the risk of major hemorrhage, compared with aspirin alone (clopidogrel + aspirin: 832/3772, 6.8%; aspirin alone: 924/3782, 7.6%, p = 0.01). Which of the following is incorrect about this study?
A. The primary study outcome was a composite outcome of any major vascular event (stroke, non–central nervous system systemic embolism, myocardial infarction, or death from vascular causes).
B. The rates of discontinuation of the study drugs were 39.4% in the study group and 37.1% in the control group at 4 years.
C. The most common antithrombotic medications used by patients who permanently discontinued the study medication were vitamin K antagonists, and aspirin alone.
D. Hong Kong was not involved in this study
Answer: D
Hong Kong was involved in this study by 580 centers in 33 countries of 7554 patients, and we recruited 86 patients.The Hong Kong researchers quoted were: W.K. Chan, H.W. Chan, J.W.H. Fung, S.K. Li and K.S. Wong.