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CURRENT OASIS - 7
CURRENT OASIS - 7
Acronym: CURRENT OASIS – 7
Description: Double-dose versus standard-dose clopidogrel and
high-dose versus low-dose aspirin in individuals undergoing
percutaneous coronary intervention for acute coronary syndromes
Source: The Lancet, Volume 376, Issue 9748, 9–15 October 2010, Pages
1203-1205
Presenters: DrShamir RMehtaMD; Jean-FrancoisTanguayMD; John
WEikelboomMD; Sanjit SJollyMD; ProfCampbell DJoynerMD; Christopher
BGrangerMD; ProfDavid PFaxonMD; Hans-JurgenRupprechtMD;
ProfAndrzejBudajMD; AlvaroAvezumMD; ProfPetrWidimskyMD; ProfPhilippe
GabrielStegMD; ProfJean-PierreBassandMD; GillesMontalescotMD;
CarlosMacayaMD; GiuseppeDi PasqualeMD; KariNiemelaMD; Andrew
EAjaniMD; ProfSalimYusufMBBS
Trial objective: To assess the effect of various clopidogrel and aspirin
regimens in prevention of major cardiovascular events and stent thrombosis
in patients undergoing PCI.
CURRENT OASIS - 7
Trial design: Randomised factorial trial; double-blinded assessment
Sample size: 25,086 individuals from 597 centres in 39 countries.
Inclusion criteria: Individuals with acute coronary syndromes and
intended early PCI
CURRENT OASIS - 7
Methodology:
 Individuals were randomly assigned to double-dose (600 mg on day
1, 150 mg on days 2–7, then 75 mg daily) versus standard-dose (300
mg on day 1 then 75 mg daily) clopidogrel, and high-dose (300–325
mg daily) versus low-dose (75–100 mg daily) aspirin.
 Randomisation was done with a 24 h computerised central
automated voice response system.
 The clopidogrel dose comparison was double-blind and the aspirin
dose comparison was open label with blinded assessment of
outcomes.
CURRENT OASIS - 7
Results:
 8560 patients were assigned to double-dose and 8703 to
standard-dose clopidogrel (8558 and 8702 completed 30-day
follow-up, respectively), and 8624 to high-dose and 8639 to low-
dose aspirin (8622 and 8638 completed 30-day follow-up,
respectively).
 Compared with the standard dose, double-dose clopidogrel
reduced the rate of the primary outcome (330 events
[3·9%] vs 392 events [4·5%]; adjusted hazard ratio 0·86, 95% CI
0·74–0·99, p=0·039) and definite stent thrombosis (58
[0·7%] vs 111 [1·3%]; 0·54 [0·39–0·74], p=0·0001).
Continued….
CURRENT OASIS - 7
 High-dose and low-dose aspirin did not differ for the primary
outcome (356 [4·1%] vs 366 [4·2%]; 0·98, 0·84–1·13, p=0·76).
Major bleeding was more common with double-dose than
with standard-dose clopidogrel (139 [1·6%] vs 99 [1·1%];
1·41, 1·09–1·83, p=0·009) and did not differ between high-
dose and low-dose aspirin (128 [1·5%] vs 110 [1·3%]; 1·18,
0·92–1·53, p=0·20).
CURRENT OASIS - 7
Conclusion:
 In patients undergoing PCI for acute coronary syndromes, a 7-day
double-dose clopidogrel regimen was associated with a reduction
in cardiovascular events and stent thrombosis compared with the
standard dose.
 Efficacy and safety did not differ between high-dose and low-dose
aspirin.
 A double-dose clopidogrel regimen can be considered for all
patients with acute coronary syndromes treated with an early
invasive strategy and intended early PCI.
CURRENT OASIS - 7

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Current Oasis - 7

  • 2. CURRENT OASIS - 7 Acronym: CURRENT OASIS – 7 Description: Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes
  • 3. Source: The Lancet, Volume 376, Issue 9748, 9–15 October 2010, Pages 1203-1205 Presenters: DrShamir RMehtaMD; Jean-FrancoisTanguayMD; John WEikelboomMD; Sanjit SJollyMD; ProfCampbell DJoynerMD; Christopher BGrangerMD; ProfDavid PFaxonMD; Hans-JurgenRupprechtMD; ProfAndrzejBudajMD; AlvaroAvezumMD; ProfPetrWidimskyMD; ProfPhilippe GabrielStegMD; ProfJean-PierreBassandMD; GillesMontalescotMD; CarlosMacayaMD; GiuseppeDi PasqualeMD; KariNiemelaMD; Andrew EAjaniMD; ProfSalimYusufMBBS Trial objective: To assess the effect of various clopidogrel and aspirin regimens in prevention of major cardiovascular events and stent thrombosis in patients undergoing PCI. CURRENT OASIS - 7
  • 4. Trial design: Randomised factorial trial; double-blinded assessment Sample size: 25,086 individuals from 597 centres in 39 countries. Inclusion criteria: Individuals with acute coronary syndromes and intended early PCI CURRENT OASIS - 7
  • 5. Methodology:  Individuals were randomly assigned to double-dose (600 mg on day 1, 150 mg on days 2–7, then 75 mg daily) versus standard-dose (300 mg on day 1 then 75 mg daily) clopidogrel, and high-dose (300–325 mg daily) versus low-dose (75–100 mg daily) aspirin.  Randomisation was done with a 24 h computerised central automated voice response system.  The clopidogrel dose comparison was double-blind and the aspirin dose comparison was open label with blinded assessment of outcomes. CURRENT OASIS - 7
  • 6. Results:  8560 patients were assigned to double-dose and 8703 to standard-dose clopidogrel (8558 and 8702 completed 30-day follow-up, respectively), and 8624 to high-dose and 8639 to low- dose aspirin (8622 and 8638 completed 30-day follow-up, respectively).  Compared with the standard dose, double-dose clopidogrel reduced the rate of the primary outcome (330 events [3·9%] vs 392 events [4·5%]; adjusted hazard ratio 0·86, 95% CI 0·74–0·99, p=0·039) and definite stent thrombosis (58 [0·7%] vs 111 [1·3%]; 0·54 [0·39–0·74], p=0·0001). Continued…. CURRENT OASIS - 7
  • 7.  High-dose and low-dose aspirin did not differ for the primary outcome (356 [4·1%] vs 366 [4·2%]; 0·98, 0·84–1·13, p=0·76). Major bleeding was more common with double-dose than with standard-dose clopidogrel (139 [1·6%] vs 99 [1·1%]; 1·41, 1·09–1·83, p=0·009) and did not differ between high- dose and low-dose aspirin (128 [1·5%] vs 110 [1·3%]; 1·18, 0·92–1·53, p=0·20). CURRENT OASIS - 7
  • 8. Conclusion:  In patients undergoing PCI for acute coronary syndromes, a 7-day double-dose clopidogrel regimen was associated with a reduction in cardiovascular events and stent thrombosis compared with the standard dose.  Efficacy and safety did not differ between high-dose and low-dose aspirin.  A double-dose clopidogrel regimen can be considered for all patients with acute coronary syndromes treated with an early invasive strategy and intended early PCI. CURRENT OASIS - 7