Why the study?
Does loading with 300 mg clopidogrel plus aspirin followed by dual antiplatelet therapy reduce the rate of recurrent stroke in patients with a very recent transient ischemic attack or minor ischemic stroke?
Does loading with 300 mg clopidogrel plus aspirin followed by dual antiplatelet therapy reduce the rate of recurrent stroke in patients with a very recent transient ischemic attack or minor ischemic stroke?
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A front-loading approach with clopidogrel and aspirin followed by short-term dual antiplatelet therapy reduces early recurrent stroke risk in patients with recent TIA or minor ischemic stroke.
Dual antiplatelet therapy with aspirin plus clopidogrel is not recommended for secondary stroke prevention because of lack of effectiveness and increased hemorrhagic risk. Recent studies show that in patients with a very recent transient ischemic attack or minor ischemic stroke loading with 300 mg clopidogrel plus aspirin, followed by clopidogrel 75 mg plus aspirin once daily for up to 90 days significantly decreases the rate of recurrent stroke, especially strokes that occur within few days from the event that led to medical attention, without an increase in severe bleedings. This article reviews the pharmacokinetics and pharmacodynamics of clopidogrel, focusing on loading doses, and summarizes the results of the studies that have shown the effectiveness of the front-loading approach in the early secondary prevention of stroke.
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Bruno Censori (2014) studied this question.
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