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Update on antiplatelet agents, including MATCH, CHARISMA, and ESPRIT

Maryna Skliut1, Dara G Jamieson

  • 1New York - Presbyterian Hospital, Weill Medical College of Cornell University, Department of Neurology and Neuroscience, 525 East 68th Street, Suite F-610, New York, NY 10021, USA.

Current Cardiology Reports
|April 18, 2008
PubMed

Insights

For secondary stroke prevention, aspirin plus extended-release dipyridamole offers benefits over monotherapy. However, aspirin plus clopidogrel does not show added benefit and increases bleeding risks.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Secondary prevention of ischemic stroke and transient ischemic attack (TIA) relies on risk factor modification.
  • Atherothrombotic disease, involving platelet activation and aggregation, underlies most noncardioembolic ischemic strokes.
  • Antiplatelet medications are crucial for secondary stroke prevention in arterial disease.

Purpose of the Study:

  • To review recent studies on antiplatelet medications for secondary stroke prevention.
  • To discuss the efficacy and controversies surrounding combination antiplatelet therapy.

Main Methods:

  • Review of recent clinical studies and trials on antiplatelet agents.
  • Analysis of combination therapies including aspirin with extended-release dipyridamole or clopidogrel.

Main Results:

  • Aspirin plus extended-release dipyridamole demonstrated additive benefits compared to monotherapy.
  • Aspirin plus clopidogrel did not show superior efficacy in preventing recurrent ischemic stroke over individual agents.
  • Combination therapy with aspirin and clopidogrel increased the risk of hemorrhagic side effects.

Conclusions:

  • Combination antiplatelet therapy requires careful consideration of risks and benefits.
  • Aspirin plus extended-release dipyridamole is a viable option for secondary stroke prevention.
  • Further research is needed to clarify optimal antiplatelet strategies and address existing controversies.

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