Dual Antiplatelet Therapy With Clopidogrel and Aspirin in Symptomatic Carotid Stenosis Evaluated Using Doppler Embolic Signal Detection
Key result
Dual therapy with clopidogrel and aspirin significantly reduced the proportion of patients with asymptomatic microembolic signals at day 7 compared to aspirin alone (43.8% vs 72.7%; P=0.0046).
Why the study?
Does dual antiplatelet therapy with clopidogrel and aspirin reduce asymptomatic microembolic signals compared to aspirin monotherapy in patients with recently symptomatic carotid stenosis?
Population
107 patients with recently symptomatic ≥50% carotid stenosis and asymptomatic microembolic signals detected…
Comparison
Clopidogrel and aspirin vs Aspirin monotherapy
Design
RCT, randomized, double-blind
Follow-up
7 days
Authors
Discussion
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Implication
Supports dual antiplatelet therapy in recently symptomatic carotid stenosis; extends randomized evidence on microembolic signal reduction.
Study Design
Type
RCT (n=107)
Blinding
Double-blind
Randomization
randomized
Multicenter
Yes
Structured PICO
Does dual antiplatelet therapy with clopidogrel and aspirin reduce asymptomatic microembolic signals compared to aspirin monotherapy in patients with recently symptomatic carotid stenosis?
P
Population
107 patients with recently symptomatic ≥50% carotid stenosis and asymptomatic microembolic signals (MES) detected by transcranial Doppler ultrasound
I
Intervention
Clopidogrel and aspirin (dual antiplatelet therapy)
C
Comparator
Aspirin monotherapy
O
Outcome
Proportion of patients positive for microembolic signals (MES) on day 7surrogate
Main Result
Effect estimate: RRR 39.8% (95% CI 13.8 to 58.0)
Absolute Event Rate: 43.8% vs 72.7%
p-value: p=0.0046
In patients with recently symptomatic carotid stenosis, dual antiplatelet therapy with clopidogrel and aspirin significantly reduces asymptomatic microembolic signals compared to aspirin alone.
Cite This Study
Markus et al. (2005) conducted an RCT in Symptomatic carotid stenosis (n=107). Clopidogrel and aspirin vs. Aspirin monotherapy was evaluated on Microembolic signals (MES) positive on day 7 (RRR 39.8%, 95% CI 13.8 to 58.0, p=0.0046). Dual therapy with clopidogrel and aspirin significantly reduced the proportion of patients with asymptomatic microembolic signals at day 7 compared to aspirin alone (43.8% vs 72.7%; P=0.0046).