--- title: "Relative efficacy and safety of clopidogrel in women and men | Sutter Health" description: "Clopidogrel reduces the risk of cardiovascular events in both women and men." url: "https://www.sutterhealth.org/research/publications/relative-efficacy-and-safety-of-clopidogrel-in-women-and-men-1055312590" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Relative efficacy and safety of clopidogrel in women and men # The relative efficacy and safety of clopidogrel in women and men a sex-specific collaborative meta-analysis. Berger JS, Bhatt DL, Cannon CP, Chen Z, Jiang L, Jones JB, Mehta SR, Sabatine MS, Steinhubl SR, Topol EJ, & Berger PB. _J Am Coll Cardiol. 54(21):1935-45. doi: 10.1016/j.jacc.2009.05.074._ 2009-11-17 ## Abstract OBJECTIVES: This study sought to investigate the efficacy and safety of clopidogrel in women and men. BACKGROUND: Previous analyses have shown sex-based differences in response to several antiplatelet medications. Little is known about the efficacy and safety of clopidogrel in women and men. METHODS: This study performed a meta-analysis of all blinded randomized clinical trials comparing clopidogrel and placebo (CURE \[Clopidogrel in Unstable Angina to Prevent Recurrent Events\], CREDO \[Clopidogrel for the Reduction of Events During Observation\], CLARITY-TIMI 28 \[Clopidogrel as Adjunctive Reperfusion Therapy-Thrombolysis In Myocardial Infarction 28\], COMMIT \[Clopidogrel and Metoprolol in Myocardial Infarction Trial\], and CHARISMA \[Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance\] trials), involving a total of 79,613 patients, of whom 30% were women. The relative efficacy and safety of clopidogrel at reducing cardiovascular events (cardiovascular death, myocardial infarction \[MI\], or stroke) in women and men was estimated using random-effects modeling. RESULTS: Overall, clopidogrel was associated with a highly significant 14% proportional reduction in the risk of cardiovascular events (odds ratio \[OR\]: 0.86; 95% confidence interval \[CI\]: 0.80 to 0.93), with no significant differences in treatment effect between women and men. Among the 23,533 women enrolled, there were fewer cardiovascular events in the clopidogrel group compared with the placebo group (11.0% vs. 11.8%; OR: 0.93; 95% CI: 0.86 to 1.01). In women the risk reduction with clopidogrel seemed to be greatest for MI (OR: 0.81; 95% CI: 0.70 to 0.93), with the effects on stroke (OR: 0.91; 95% CI: 0.69 to 1.21) or total death (OR: 0.99; 95% CI: 0.90 to 1.08) not statistically significant. Among the 56,091 men enrolled, there were fewer cardiovascular events in those receiving clopidogrel compared with placebo (7.8% vs. 9.0%; OR: 0.84; 95% CI: 0.78 to 0.91), and the risk reduction was significant for MI (OR: 0.83; 95% CI: 0.76 to 0.92), stroke (OR: 0.83; 95% CI: 0.71 to 0.96), and total death (OR: 0.91; 95% CI: 0.84 to 0.97). Clopidogrel increased the risk of major bleeding in both women (OR: 1.43; 95% CI: 1.15 to 1.79) and men (OR: 1.22; 95% CI: 1.05 to 1.42). CONCLUSIONS: Clopidogrel reduces the risk of cardiovascular events in both women and men. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/19909874) ![J.B. Jones, Ph.D., MBA](https://dyn.mktgcdn.com/p/rIQfkoa5XfKJYCHSVrDKsACQSNJ7jTljZTHKC4Lae2E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) J.B. Jones, Ph.D., MBA Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jb-jones-phd-mba-1049680984) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Cerebrovascular Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cerebrovascular+Disorders%5C%22%22) - [Men's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Men%27s+Health%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Racial/ethnic differences in hypertension prevalence, treatment, and control for outpatients in Northern California 2010-2012.](https://www.sutterhealth.org/research/publications/racial-ethnic-differences-in-htn-prevalence-and-tx-1055312916) Zhao B, Jose PO, Pu J, Chung S, Ancheta IB, Fortmann SP, Palaniappan LP. Am J Hypertension. pii: hpu189. \[Epub ahead of print\] 2014 Oct 28 - Publication ### [Geographic variations in cardiovascular disease mortality among Asian American subgroups, 2003-2011.](https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318) Pu J, Hastings KG, Boothroyd D, Jose PO, Chung S, Shah JB, Cullen MR, Palaniappan LP, Rehkopf DH. J Am Heart Assoc. 6(7). pii: e005597. doi: 10.1161/JAHA.117.005597. 2017 Jul 12 - Publication ### [Gender differences in weight-related attitudes and behaviors among overweight and obese adults in the United States.](https://www.sutterhealth.org/research/publications/gender-differences-in-wt-behaviors-in-obese-adults-1055312812) Tsai SA, Lv N, Xiao L, Ma J. Am J Mens Health. pii: 1557988314567223. \[Epub ahead of print\] 2015 Jan 15 - Publication ### [Dabigatran versus warfarin for atrial fibrillation in real-world clinical practice: a systematic review and meta-analysis.](https://www.sutterhealth.org/research/publications/dabigatran-vs-warfarin-atrial-fibrillation-1055312522) Romanelli RJ, Nolting L, Dolginsky M, Kym E, Orrico KB. Circ Cardiovasc Qual Outcomes. pii: CIRCOUTCOMES.115.002369. \[Epub ahead of print\] 2016 Jan 26 - Publication ### [Utilization of cardiac monitoring tests in women with non-metastatic breast cancer treated with trastuzumab.](https://www.sutterhealth.org/research/publications/cardiac-monitoring-breast-cancer-trastuzumab-1055312857) Shin J, Liang SY, Hassett MJ, Phillips KA, Haas JS. Personalized Medicine. 10(7): 703-708. 2013 Jan 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/relative-efficacy-and-safety-of-clopidogrel-in-women-and-men-1055312590#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Relative efficacy and safety of clopidogrel in women and men"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/relative-efficacy-and-safety-of-clopidogrel-in-women-and-men-1055312590#medicalscholarlyarticle","name":"The relative efficacy and safety of clopidogrel in women and men a sex-specific collaborative meta-analysis.","headline":"Relative efficacy and safety of clopidogrel in women and men","abstract":"OBJECTIVES: This study sought to investigate the efficacy and safety of clopidogrel in women and men. BACKGROUND: Previous analyses have shown sex-based differences in response to several antiplatelet medications. Little is known about the efficacy and safety of clopidogrel in women and men. METHODS: This study performed a meta-analysis of all blinded randomized clinical trials comparing clopidogrel and placebo (CURE [Clopidogrel in Unstable Angina to Prevent Recurrent Events], CREDO [Clopidogrel for the Reduction of Events During Observation], CLARITY-TIMI 28 [Clopidogrel as Adjunctive Reperfusion Therapy-Thrombolysis In Myocardial Infarction 28], COMMIT [Clopidogrel and Metoprolol in Myocardial Infarction Trial], and CHARISMA [Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance] trials), involving a total of 79,613 patients, of whom 30% were women. The relative efficacy and safety of clopidogrel at reducing cardiovascular events (cardiovascular death, myocardial infarction [MI], or stroke) in women and men was estimated using random-effects modeling. RESULTS: Overall, clopidogrel was associated with a highly significant 14% proportional reduction in the risk of cardiovascular events (odds ratio [OR]: 0.86; 95% confidence interval [CI]: 0.80 to 0.93), with no significant differences in treatment effect between women and men. Among the 23,533 women enrolled, there were fewer cardiovascular events in the clopidogrel group compared with the placebo group (11.0% vs. 11.8%; OR: 0.93; 95% CI: 0.86 to 1.01). In women the risk reduction with clopidogrel seemed to be greatest for MI (OR: 0.81; 95% CI: 0.70 to 0.93), with the effects on stroke (OR: 0.91; 95% CI: 0.69 to 1.21) or total death (OR: 0.99; 95% CI: 0.90 to 1.08) not statistically significant. Among the 56,091 men enrolled, there were fewer cardiovascular events in those receiving clopidogrel compared with placebo (7.8% vs. 9.0%; OR: 0.84; 95% CI: 0.78 to 0.91), and the risk reduction was significant for MI (OR: 0.83; 95% CI: 0.76 to 0.92), stroke (OR: 0.83; 95% CI: 0.71 to 0.96), and total death (OR: 0.91; 95% CI: 0.84 to 0.97). Clopidogrel increased the risk of major bleeding in both women (OR: 1.43; 95% CI: 1.15 to 1.79) and men (OR: 1.22; 95% CI: 1.05 to 1.42). 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