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December 19, 2012

Treatment With Clopidogrel After Myocardial Infarction—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Department of Cardiology, Gentofte Hospital, Hellerup, Denmark (ca@heart.dk)

JAMA. 2012;308(23):2456-2457. doi:10.1001/jama.2012.28741

In Reply: As pointed out by Dr Lin and colleagues, diverging data regarding clopidogrel efficacy between men and women have been reported repeatedly and have caused concerns as to whether women benefit as much from clopidogrel treatment as men. We analyzed the data from the present study by sex and found no evidence of a sex-specific effect.

Lin and colleagues also requested analyses stratified by diabetes duration, presumably because cardiovascular adverse event rates may increase with longer duration of diabetes. As a rough proxy for diabetes duration and severity, we investigated whether a different association with clopidogrel was apparent for those who used insulin compared with those who did not use insulin. We found no evidence of such a differential association.