Author + information
- Robert S Dieter, MDa
Dr. Berger et al. presented a cogent comparison of ticlopidine and clopidogrel after intracoronary artery stent placement (1). However, they present misleading information regarding the side effects of clopidogrel. They state, “Clopidogrel does not cause neutropenia … ” (1). The authors use the CAPRIE trial as a supporting reference. In the CAPRIE trial “ … the numbers for low neutrophil counts were ten (0.10%) and 16 (0.17%) (clopidogrel and aspirin groups, respectively). Among these latter cases, the neutrophil count fell below 0.45 × 10^9/L for five (0.05%) and four (0.04%) patients in the clopidogrel and aspirin groups, respectively., … In CAPRIE, there was no excess neutropenia in the clopidogrel group (2).” Hence, more appropriately, the authors should have stated that the risk of neutropenia is less than with ticlopidine but essentially equivalent to aspirin.
It is important for cardiologists to remember that clopidogrel can be associated with neutropenia, albeit very infrequently.
- American College of Cardiology