Twenty-three studies were included (n=13,475, including 3,505 who were exposed to clopidogrel). These comprised four RCTs (n= 2,302), eight prospective observational studies (n=3,579), 10 retrospective studies (n=7,023) and one prospective/retrospective study (n=571). Treatment arm size ranged from 8 to 1,944.
Four of seven studies reported significantly higher chest tube output in clopidogrel exposed compared to nonexposed patients.
Studies not specifying that aprotinin was used: four of five studies reported significantly greater platelet transfusion requirements in clopidogrel exposed compared to nonexposed patients. The authors stated that there was a trend towards higher reoperation rates in clopidogrel exposed patients (this appeared to be based on four of 11 studies that showed significantly higher reoperation rates in clopidogrel exposed patients for all subgroups presented for individual studies).
The authors stated that no obvious trend was found between clopidogrel exposed and nonexposed patients for mortality, stroke, myocardial infarction or duration of ventilation or hospital stay.