Efficacy of Clopidogrel and Clinical Outcome When Clopidogrel Is Coadministered With Atorvastatin and Lansoprazole

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Critical Appraisal: Zhang, J.-r.et al., 2015. Efficacy of Clopidogrel and Clinical Outcome When
Clopidogrel Is Coadministered With Atorvastatin and Lansoprazole; A Prospective,
Randomized, Controlled Trial. Medicine, 94(50), pp. 1-8.
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Critical Appraisal: Zhang, J.-r.et al., 2015. Efficacy of Clopidogrel and Clinical Outcome
When Clopidogrel Is Coadministered With Atorvastatin and Lansoprazole; A Prospective,
Randomized, Controlled Trial. Medicine, 94(50), pp. 1-8.
The focus of Zhang, et al. (2015) study was to determine the effectiveness of using
clopidogrel in clinical outcomes when it is administered with Atorvastatin and Lansoprazole.
This study entailed one hundred and four adult patients with the non-ST-segment elevated acute
coronary syndrome (NSTE-ACS) and had undergone percutaneous coronary intervention (PCI)
with drug-eluting stent implantation. The patients were all treated with antiplatelet therapy
(DAPT) and rosuvastatin was given as an additional drug to all patients. But after the sixth day,
the patents were divided into four different groups which were used to measure the differences in
the two groups. In a randomized control trial, there must be a general group and the control
group. In this case, the control group was based on the use of clopidogrel and rosuvastatin in
clinical outcomes for dual antiplatelet therapy.
To be called a randomized control trial, Zhong (2019, p. 53) sugges that the participants
in the study group must be randomly put in any group to avoid bias. This means that the patients
can fall either in the control group or the general group. In this study, all the patients received the
same medication as required and then they were randomly placed in four groups after the first
assessment. The index of the patients' response to drugs was then retested after 15-30 days where
all the patients that participated in the study were supposed to be maintained on the treatment for
six months. This study blinded the patients and they were not aware of the different groups that
existed.
According to Baker, et al. (2017) the success of randomized control trials is based on
analyzing the patients within the groups to which they belong to. This means that the researchers

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are supposed to analyze patients in the group that they belong to so that demographic factors that
may lead to other changes can be accounted for. Initially, the patients were analyzed within their
groups while still in the facility but they were the discharged and thus the researchers were
required to follow them up for a period of six months to determine any effects or challenges that
they may face while using the medication. This means that the main focus of this study was in
the control group which was supposed to report the effects clopidogrel when administered with
Atorvastatin and Lansoprazole.
Bondemark & Ruf (2015, p. 459) adds that in most cases, studies are supposed to focus
on reducing bias from the researcher, the patient, and even the health workers when carrying out
a randomized control study. This has been attributed to increased reliability of the data collected
because it does not give room to manipulate the results in their favor. Hrobjartsson, et al. (2014,
p. 1277) suggests that a good randomized control trial must have at least blinded patients if the
rest of the participants in the study cannot be blinded. This means that it is easy to have better
outcomes for the study if patients are blinded so that bias is not created. In some cases, blinding
of researchers and health workers is not a must due to the nature of the control group. In this
case, the effect of the control group was supposed to be based on measuring the changes between
the two groups so that a conclusion can be drawn from the study. As seen in this study, the health
workers and the researchers were not blinded and were aware of the four groups that the patients
had been put in and thus were required to record the changes as they were observed in the
patients. Non-blinding in these two groups was to ensure that inconsistencies between the two
groups are reduced.
Since this is a randomized control trial, then it means that at the beginning of the study all
the groups must be similar. The fact that two groups exist within a randomized control trial does