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Prevention with low-dose aspirin plus dipyridamole in patients with disabling stroke

Diederik W J Dippel1, Lisette Maasland, Patricia Halkes

  • 1Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. d.dippel@erasmusmc.nl

Stroke
|October 2, 2010
PubMed

Insights

The combination of aspirin and dipyridamole effectively reduces vascular events in patients post-stroke, regardless of stroke severity. This combination therapy offers consistent benefits across all modified Rankin Scale scores.

Area of Science:

  • Neurology
  • Cardiology
  • Clinical Pharmacology

Background:

  • Low-dose aspirin plus dipyridamole is established for secondary stroke prevention.
  • Its efficacy in patients with disabling strokes (higher mRS scores) remains less understood.

Purpose of the Study:

  • To evaluate the effectiveness of aspirin plus dipyridamole versus aspirin alone in patients with varying stroke severities.
  • Specifically assess outcomes based on modified Rankin Scale (mRS) scores at baseline.

Main Methods:

  • Reanalysis of data from 5700 patients in ESPRIT and ESPS-2 trials.
  • Stratified analysis based on baseline mRS scores (0-5).
  • Proportional hazards regression used to estimate treatment effects and test for interactions.

Main Results:

  • The combination therapy showed a relative risk of 0.79 (95% CI, 0.69-0.91) for vascular events compared to aspirin alone across all mRS scores.
  • Benefits were observed across mRS subcategories 0-4 for vascular events and stroke.
  • A trend towards benefit was suggested for patients with mRS score 5, though data were limited.

Conclusions:

  • The combination of low-dose aspirin and dipyridamole provides consistent benefits in preventing vascular events.
  • This efficacy extends across all stroke severity levels, as indicated by the modified Rankin Scale scores.
Abstract

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