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Published on: February 28, 2012

Combination aspirin and clopidogrel for secondary prevention of ischemic stroke

Thalia S Field1, Makoto Nakajima, Oscar R Benavente

  • 1Division of Neurology, (Department of Medicine), Vancouver Stroke Program, Brain Research Center, University of British Columbia, S169-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada, thalia.field@ubc.ca.

Current Treatment Options in Cardiovascular Medicine
|March 30, 2013
PubMed

Insights

Short-term dual antiplatelet therapy with aspirin and clopidogrel significantly reduced stroke recurrence in high-risk patients after a minor stroke or transient ischemic attack (TIA). This combination therapy, initiated early, shows promise for secondary stroke prevention.

Area of Science:

  • Neurology
  • Cardiology
  • Clinical Trials

Background:

  • Antiplatelet agents are crucial for preventing noncardioembolic cerebral ischemic events.
  • Long-term dual therapy with aspirin and clopidogrel lacks clear evidence for secondary stroke prevention.
  • The efficacy of short-term combination therapy requires further clarification.

Purpose of the Study:

  • To evaluate the efficacy of a short course of combination aspirin and clopidogrel for secondary stroke prevention.
  • To assess the impact of early initiation of dual antiplatelet therapy on stroke recurrence.

Main Methods:

  • The CHANCE trial investigated combination aspirin/clopidogrel versus aspirin alone in patients with minor stroke or TIA.
  • Treatment involved a 21-day course of dual antiplatelet therapy initiated within 24 hours.
  • Stroke recurrence at 90 days was the primary outcome measure.

Main Results:

  • A short course (21 days) of aspirin and clopidogrel reduced stroke recurrence at 90 days compared to aspirin alone.
  • This benefit was observed in high-risk patients with acute non-disabling cerebrovascular events.
  • Preliminary data suggests a significant reduction in stroke recurrence.

Conclusions:

  • Short-term dual antiplatelet therapy (aspirin/clopidogrel) initiated early may be effective for secondary prevention after minor stroke or TIA.
  • Ongoing trials are needed to confirm these findings and establish the role of this therapy.
  • These results offer new insights into managing acute non-disabling cerebrovascular events.
Abstract

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