Combination Therapy With Clopidogrel and Aspirin

S everal antiplatelet agents with different mechanisms of action are currently available for secondary prevention of ischemic stroke. When used as a single agent, the efficacy of antiplatelet therapy is modest. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; however, it provides only an approximately 15% relative risk reduction for secondary prevention of stroke or other major vascular events. 1 Combining 2 antiplatelet agents with different mechanisms of action was demonstrated to provide a substantial increase in efficacy in the ESPS II study. Importantly, the risk of major bleeding attributable to the combination therapy was no greater than that seen with aspirin alone.