Antiplatelet monotherapy with clopidogrel or ticagrelor may be safer and more effective for secondary prevention of cardiovascular events than aspirin alone, results from a large meta-analysis show.

The team of international doctors report that adults with coronary artery disease (CAD) given a P2Y₁₂ inhibitor as the sole antithrombotic agent had a 12% lower risk of cardiovascular death, MI and stroke than those given aspirin.

And while the risk of major bleeds was similar, patients prescribed clopidogrel or ticagrelor were 25% less likely to experience gastrointestinal (GI) bleeding.

“Given its superior efficacy and similar overall safety, P2Y₁₂ inhibitor monotherapy might be preferred over aspirin monotherapy for long-term secondary prevention in patients with established CAD,” the researchers concluded.