Stroke Risk Down With Clopidogrel + Aspirin Post-TIA
(HealthDay News) – For patients with transient ischemic attack (TIA) or minor stroke, the risk of stroke in the first 90 days is reduced with clopidogrel and aspirin vs. aspirin alone, according to a study published online June 26 in the New England Journal of Medicine in advance of presentation at the Tiantan International Stroke Conference, held from June 28–30 in Beijing.
Yongjun Wang, M.D., from the Beijing Tiantan Hospital, and colleagues conducted a randomized, double-blind, placebo-controlled trial involving 5,170 patients within 24 hours after the onset of minor ischemic stroke or high-risk TIA at 14 centers in China. The authors sought to compare the effects of clopidogrel plus aspirin with placebo plus aspirin for 90 days. The primary outcome was stroke during 90 days of follow-up.
The researchers found that stroke occurred in significantly fewer patients in the clopidogrel-aspirin group vs. the placebo-aspirin group (8.2% vs. 11.7%; hazard ratio, 0.68). Moderate or severe hemorrhage occurred in 0.3% of participants in each group, and the rate of hemorrhagic stroke was 0.3% in each group.
"Among patients with TIA or minor stroke who can be treated within 24 hours after the onset of symptoms, the combination of clopidogrel and aspirin is superior to aspirin alone for reducing the risk of stroke in the first 90 days and does not increase the risk of hemorrhage," the authors write.