Addition of clopidogrel to aspirin, but not early use of metoprolol, improved overall outcome in acute myocardial infarction.

and commentary also appear in ACP Journal Club. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For correspondence: Dr Z Chen, Clinical Trial Service Unit, Oxford, UK. [email protected] Sources of funding: Sanofi-Aventis; Bristol-Myers Squibb; AstraZeneca. Table 1. Clopidogrel (Clop) plus aspirin v aspirin alone for acute myocardial infarction at up to 28 days* Outcomes Clop + aspirin Aspirin RRR (95% CI) NNT (CI) Composite end point 9.2% 10.1% 8.2% (2.7 to 13) 122 (78 to 367) Death 7.5% 8.1% 6.5% (0.9 to 12) 192 (103 to 1349) Reinfarction 2.1% 2.4% 14% (2.9 to 24) 302 (176 to 1413) Stroke 0.9% 1.1% 14% (23.0 to 28) Not significant