Back to Search
Start Over
Recurrent Ischemic Lesions After Acute Atherothrombotic Stroke: Clopidogrel Plus Aspirin Versus Aspirin Alone.
- Source :
-
Stroke [Stroke] 2016 Sep; Vol. 47 (9), pp. 2323-30. Date of Electronic Publication: 2016 Jul 14. - Publication Year :
- 2016
-
Abstract
- Background and Purpose: In patients with acute ischemic stroke caused by large artery atherosclerosis, clopidogrel plus aspirin versus aspirin alone might be more effective to prevent recurrent cerebral ischemia. However, there is no clear evidence.<br />Methods: In this multicenter, double-blind, placebo-controlled trial, we randomized 358 patients with acute ischemic stroke of presumed large artery atherosclerosis origin within 48 hours of onset to clopidogrel (75 mg/d without loading dose) plus aspirin (300-mg loading followed by 100 mg/d) or to aspirin alone (300-mg loading followed by 100 mg/d) for 30 days. The primary outcome was new symptomatic or asymptomatic ischemic lesion on magnetic resonance imaging within 30 days. Secondary outcomes were 30-day functional disability, clinical stroke recurrence, and composite of major vascular events. Safety outcome was any bleeding.<br />Results: Of 358 patients enrolled, 334 (167 in each group) completed follow-up magnetic resonance imaging. The 30-day new ischemic lesion recurrence rate was comparable between the clopidogrel plus aspirin and the aspirin monotherapy groups (36.5% versus 35.9%; relative risk, 1.02; 95% confidence interval, 0.77-1.35; P=0.91). Of the recurrent ischemic lesions, 94.2% were clinically asymptomatic. There were no differences in secondary outcomes between the 2 groups. Any bleeding were more frequent in the combination group than in the aspirin monotherapy group, but the difference was not significant (16.7% versus 10.7%; P=0.11). One hemorrhagic stroke occurred in the clopidogrel plus aspirin group.<br />Conclusions: Clopidogrel plus aspirin might not be superior to aspirin alone for preventing new ischemic lesion and clinical vascular events in patients with acute ischemic stroke caused by large artery atherosclerosis.<br />Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00814268.<br /> (© 2016 American Heart Association, Inc.)
- Subjects :
- Aged
Atherosclerosis diagnostic imaging
Atherosclerosis drug therapy
Brain diagnostic imaging
Brain Ischemia diagnostic imaging
Brain Ischemia drug therapy
Brain Ischemia etiology
Clopidogrel
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Secondary Prevention
Stroke diagnostic imaging
Stroke drug therapy
Thrombosis diagnostic imaging
Thrombosis drug therapy
Ticlopidine therapeutic use
Aspirin therapeutic use
Atherosclerosis complications
Brain Ischemia prevention & control
Platelet Aggregation Inhibitors therapeutic use
Stroke complications
Thrombosis complications
Ticlopidine analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 47
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 27418597
- Full Text :
- https://doi.org/10.1161/STROKEAHA.115.012293