To the Editor: Dr Andersson and colleagues1 reported that among patients with diabetes compared with patients without diabetes, the use of conventional clopidogrel treatment after myocardial infarction (MI) was associated with lower reduction in the risk of all-cause death and cardiovascular death. However, we wonder whether there were differences in mortality by sex.
In a meta-analysis by Berger and colleagues,2 the risk reduction with clopidogrel in women was greatest for MI (odds ratio [OR], 0.81; 95% CI, 0.70-0.93) and not statistically significant for stroke (OR, 0.91; 95% CI, 0.69-1.21) or total death (OR, 0.99; 95% CI, 0.90-1.08). In contrast, the risk reduction with clopidogrel in men was not only significant for MI (OR, 0.83; 95% CI, 0.76-0.92), but also for stroke (OR, 0.83; 95% CI, 0.71-0.96) and total death (OR, 0.91; 95% CI, 0.84-0.97).2