The commonly prescribed blood thinner clopidogrel should replace aspirin as a routine pill for preventing heart attacks and strokes in people who already have at least some degree of heart disease, researchers reported at the European Society of Cardiology Congress.

Pooled data on nearly 29,000 patients with coronary artery disease who had participated in seven earlier randomized trials showed that those taking clopidogrel had a 14% lower risk of major adverse cardiovascular or cerebrovascular events, including heart attack, stroke, or cardiovascular death, compared to those taking aspirin, during an average follow-up of 5.5 years.

“These results suggest that clopidogrel should be considered the preferred long-term antiplatelet medication for patients with established coronary artery disease,” the researchers said.

Clopidogrel is the generic name of the widely used blood clot preventer Plavix, sold by Bristol Myers Squibb and Sanofi. Several companies sell generic clopidogrel including Aurobindo Pharma, Sun Pharma and Teva Pharmaceuticals.

Rates of anticoagulant-related side effects like ulcers and major bleeding were similar between the two drugs, dispelling concerns that clopidogrel might lead to more bleeding complications, the researchers said.

The researchers said their analysis included many types of patients and subgroups to ensure the findings, which were also published in The Lancet, applied broadly.

“Even patients who might respond less well to clopidogrel due to genetic or clinical factors still benefited from its use over aspirin,” the researchers said in a statement.

Because clopidogrel is widely available and inexpensive, the study’s findings have the potential to influence clinical guidelines worldwide and improve patient outcomes, the researchers said.