Related Experiment Videos
One year after CAPRIE, IST and ESPS 2. Any changes in concepts?
1Royal Perth Hospital, and University of Western Australia, Perth, Western Australia. gjhankey@cyllene.uwa.edu.au
Cerebrovascular Diseases (Basel, Switzerland)
|October 10, 1998
Summary
Large trials in stroke medicine demonstrate antiplatelet therapy
Area of Science:
- Neuroscience
- Cardiovascular Medicine
- Clinical Trials
Background:
- Previous large collaborative randomized trials (e.g., IST, CAPRIE, ESPS-2) have established feasibility and impact in stroke medicine.
- These studies identified risks of early anticoagulation and the benefits of early, continuous antiplatelet therapy for stroke recurrence.
- Evidence suggests varying and potentially additive effects of antiplatelet agents with different mechanisms of action.
Purpose of the Study:
- To delineate the roles of oral anticoagulant therapy and combined aspirin-dipyridamole in preventing arterial stroke.
- To inform future research directions for secondary stroke prevention strategies.
Main Methods:
- The ESPRIT trial is designed to compare specific therapeutic interventions.
- Focus on evaluating the efficacy and safety of different antithrombotic strategies.
Main Results:
- Previous trials have shown the effectiveness and safety of early antiplatelet therapy.
- Identified differing effects and potential additive benefits of combined antiplatelet agents.
Conclusions:
- The ESPRIT trial will clarify the roles of oral anticoagulants and aspirin-dipyridamole in arterial stroke prevention.
- Future trials are needed to explore novel combinations: GPIIb/IIIa inhibitors, dual antiplatelet therapy, antiplatelet-anticoagulant combinations, and antithrombotic-statin combinations.