Skepticism exists among healthcare workers and patients regarding the efficacy and safety of generic medication, despite its potential to lower healthcare costs. This study aimed to compare the outcomes of a generic clopidogrel and its brand‐name counterpart for secondary prevention in patients with acute myocardial infarction (AMI). Using the Taiwan National Health Insurance Research Database, we identified 49,325 patients who were hospitalized for AMI between January 1, 2008 and December 31, 2013 and prescribed either generic or brand‐name clopidogrel. Among them, 2419 (4.9%) were prescribed the generic clopidogrel. After propensity score matching, both the generic and brand‐name groups consisted of 2382 patients. The primary efficacy outcome was a composite of myocardial infarction, coronary revascularization, ischemic stroke, and all‐cause death. The primary safety outcome was major bleeding requiring hospitalization. At a mean follow‐up of 2.5 years, the generic and brand‐name clopidogrel groups had comparable risks of primary efficacy outcome (41.9% vs. 42%; hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.88–1.04), and the risks of the individual components were also similar. There were no significant differences between the two groups in major bleeding (7.9% vs. 7.9%; HR 0.99; 95% CI 0.81–1.21). Subgroup analyses also revealed no statistically significant interactions between the treatment effect and various subgroups. In this retrospective database analysis, the generic clopidogrel was comparable to its brand‐name counterpart regarding cardiovascular and bleeding outcomes for the treatment of patients with AMI.

Since 2020, new vaccines were developed to fight the coronavirus disease 2019 (COVID-19). Vaccination is important in preventing mortality and achieving herd immunity. However, due to vast vaccination, fatal adverse events could be seen. We report a case of a previously healthy, young male who had a cardiopulmonary arrest 2 min after receiving the Oxford- AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccination. After targeted temperature management, a coronary angiogram was performed after neurological recovery and showed severe stenosis at the proximal left anterior descending artery. Stenting was done and he was discharge. No similar case of sudden cardiorespiratory collapse immediately after COVID-19 vaccination has been reported. Our patient did not have any effort-related angina or dyspnea on exertion before this event. The sudden cardiorespiratory collapse was probably related to underlying coronary artery disease, complicated with a vasovagal event. We stress the importance of coronary angiography in out of hospital cardiac arrest patients after neurological recovery. In the era of COVID-19 vaccination, even though fatal adverse events following immunization are rare, heightened awareness of severe side effects needing medical attention is very important.