Key result
Clopidogrel plus aspirin reduces early neurological deterioration and recurrent stroke vs aspirin in acute LAA stroke.
Why the study?
Does clopidogrel plus aspirin reduce early neurological deterioration and recurrent ischemic stroke compared to aspirin alone in patients with acute large artery atherosclerosis stroke?
RCT (n=574)
Does clopidogrel plus aspirin reduce early neurological deterioration and recurrent ischemic stroke compared to aspirin alone in patients with acute large artery atherosclerosis stroke?
Dual antiplatelet therapy with clopidogrel and aspirin reduces early neurological deterioration and recurrent ischemic stroke within 30 days compared to aspirin alone in patients with acute large artery atherosclerosis stroke.
Answers are grounded in this paper and cite their sources.
Supports dual antiplatelet therapy in acute large artery atherosclerosis stroke; extends prior RCT evidence to this subtype.
Aims: To evaluate the effects of treatments with clopidogrel plus aspirin (dual therapy) on early neurological deterioration (END) and outcomes at 6 months in patients with acute large artery atherosclerosis (LAA) stroke. Methods: A total of 574 patients with LAA stroke were randomly assigned to receive either dual therapy or aspirin alone (monotherapy). The primary outcome was END. Secondary outcomes included recurrent ischemic stroke (RIS) and outcomes at 6 months. Results: The prevalence of END and RIS was lower in patients on dual therapy than in those on monotherapy during the 30 days. At 6 months, dual therapy improved outcomes among older patients and those with symptomatic stenosis in the posterior circulation and basilar artery. Conclusion: Clopidogrel plus aspirin is superior to aspirin alone for reducing END and RIS within 30 days and improves outcomes in certain subgroups at 6 months.
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Wang et al. (2014) conducted an RCT in acute large artery atherosclerosis (LAA) stroke (n=574). clopidogrel plus aspirin vs. aspirin alone was evaluated on early neurological deterioration (END). Clopidogrel plus aspirin reduced early neurological deterioration and recurrent ischemic stroke within 30 days compared to aspirin alone in patients with acute large artery atherosclerosis stroke.
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