Clopidogrel Added to Aspirin Adds No Benefit but Bleeding Risk in Patients With Recent Lacunar Stroke
Stroke Reports Wednesday, March 6th, 2013STROKEAHA: January 22, 2013
Patients with transient ischemic attack or ischemic stroke have a high risk of recurrent stroke. Antiplatelet therapy has shown efficacy in secondary stroke prevention and is recommended by guidelines.In patients without cardiac source of embolism aspirin, clopidogrel or the combination of aspirin and dipyridamole is recommended.
In cardiology, the combination of aspirin and clopidogrel was superior to aspirin monotherapy in the prevention of vascular events after acute coronary syndrome4 but carried a higher bleeding risk. In patients with atrial fibrillation the combination of aspirin plus clopidogrel was superior to aspirin alone in preventing strokes, but was again associated with a significant higher risk of major bleeds. In early secondary stroke prevention after transient ischemic attack or minor stroke combination, antiplatelet therapy seems to be superior to monotherapy, but larger randomized trials are needed. Read more
