The MATCH trial evaluating clopidogrel plus ASA versus clopidogrel alone enrolled 7,599 high-risk patients with recent TIA or ischemic stroke (mean age 66 years) for 18 months of follow-up.
RCT (n=7,599)
Double-blind
Randomized
Does acetylsalicylic acid added to clopidogrel reduce the composite of ischaemic stroke, myocardial infarction, vascular death and rehospitalization for an acute ischaemic event in high-risk patients with recent TIA or ischaemic stroke?
The MATCH trial is designed to evaluate whether adding acetylsalicylic acid to clopidogrel reduces vascular ischemic events in high-risk patients with recent TIA or ischemic stroke.
BACKGROUND: The CAPRIE study showed the superiority of clopidogrel over acetylsalicylic acid (ASA) for reducing the combined risk of major atherothrombotic events in patients with recent myocardial infarction (MI), recent ischaemic stroke (IS) or established peripheral arterial disease. The benefit of clopidogrel over ASA is amplified in high-risk patients. Proof of concept for the benefit of clopidogrel in addition to ASA in patients with coronary manifestations of atherothrombosis was provided by the CURE trial. METHODS: MATCH is a randomized, double-blind, placebo-controlled trial that compares clopidogrel and ASA versus clopidogrel alone in high-risk patients with recently symptomatic cerebrovascular disease. Eligible patients have experienced a transient ischaemic attack (TIA) or IS within the last 3 months and have evidence of at least 1 additional risk factor within the last 3 years (prior IS, MI, stable or unstable angina pectoris, diabetes or symptomatic peripheral arterial disease). Patients were randomized to receive ASA 75 mg once daily or placebo, with both groups receiving clopidogrel 75 mg once daily as part of standard therapy. The primary end point is the composite of IS, MI, vascular death and rehospitalization for an acute ischaemic event. The duration of treatment and follow-up is 18 months for each patient. RESULTS: Enrollment was completed in April 2002, with 7,599 patients randomized to receive the study medication. The mean age at randomization was 66 years, and the qualifying event was IS in 78.9% of patients and TIA in 21.1%. The baseline features of the study cohort indicate a population that is at a high risk for atherothrombotic recurrence. CONCLUSION: MATCH is a major ongoing trial that will provide important data on the benefit of clopidogrel and ASA compared with clopidogrel alone for reduction of vascular ischaemic events in patients with recent TIA or IS who are at high risk of atherothrombotic event recurrence.
Diener et al. (Tue,) conducted a rct in Recent transient ischaemic attack or ischaemic stroke (n=7,599). Clopidogrel and acetylsalicylic acid (ASA) vs. Clopidogrel 75 mg once daily and placebo was evaluated on Composite of ischaemic stroke, myocardial infarction, vascular death and rehospitalization for an acute ischaemic event. The MATCH trial evaluating clopidogrel plus ASA versus clopidogrel alone enrolled 7,599 high-risk patients with recent TIA or ischemic stroke (mean age 66 years) for 18 months of follow-up.