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To the Editor: In their study of death and acute myocardial infarction after stopping clopidogrel, Dr Ho and colleagues¹ concluded that there is significant thrombotic risk with increased rates of death and acute myocardial infarction in the immediate period after stopping clopidogrel. However, there are 2 pieces of information not provided in the article that could affect the validity of the conclusions.

First, the study population had a high rate of aspirin use (80%-90%) at baseline. No data were provided about how adherent the patients were with their aspirin use over the course of time after hospital discharge. It is important to know whether patients stopped aspirin therapy during the follow-up period because this would put them at a higher risk for having an acute coronary event independent of their use of clopidogrel and could have confounded the results.^2-4

Second, the dosage of aspirin that patients were taking after hospital . . . [Full Text of this Article]

Sandeep K. Goyal, MD
sandeep_mamc@rediffmail.com

Sujeeth R. Punnam, MD
Department of Internal Medicine
Michigan State University
East Lansing

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Incidence of Death and Acute Myocardial Infarction Associated With Stopping Clopidogrel After Acute Coronary Syndrome
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