Dual Antiplatelet Therapy for Non–ST Segment Elevation Acute Coronary Syndromes

Abstract This chapter appraises the CURE trial, which investigated whether adding clopidogrel to aspirin reduces major adverse cardiovascular events in patients with non–ST segment elevation acute coronary syndrome. The CURE trial recruited 12,562 patients and showed that clopidogrel significantly lowers the risk of cardiovascular death, nonfatal myocardial infarction, and stroke. The chapter discusses that clopidogrel reduces the incidence of refractory ischemia and heart failure. Although the clopidogrel group showed a higher risk of minor bleeding, the benefits of dual antiplatelet therapy are evident across various patient subgroups. Finally, the chapter considers the benefits dual antiplatelet therapy for all acute coronary syndrome patients, with at least 12 months of treatment, while considering patient-specific risk factors for bleeding and recurrent events.