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Atrial Fibrillation

Posted Friday 03 July 2009 - 14:34 PM by David Chan

First Line Drugs

  1. ACETYLSALICYLIC ACID (B01AC06)

  2. CLOPIDOGREL (B01AC04)

Reference

Comments/Instructions

Bottom line
Clopidogrel (Plavix) plus aspirin provides a small reduction in disabling stroke (number needed to treat [NNT] = 200 for 3.6 years), but causes an increased risk of major hemorrhage (number needed to treat to harm [NNTH] = 143 for 3.6 years). At a cost of approximately $1000 per year for clopidogrel, the cost to prevent a single disabling stroke is $720,000, although presumably preventing a disabling stroke will reduce the subsequent costs of care for that person. A cost-effectiveness analysis is needed to determine whether this small net benefit is worth the cost. (LOE = 1b)

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