Key result
In patients with acute ischemic stroke, dual therapy with clopidogrel and aspirin reduced the absolute proportion of poor functional outcome (mRS 2-6) at 90 days by 1.70% compared to aspirin alone.
Why the study?
Stroke is a major cause of morbidity, mortality, and disability, motivating an evaluation of combination clopidogrel and aspirin versus aspirin alone in acute ischemic stroke.
Does dual antiplatelet therapy with clopidogrel and aspirin improve functional outcomes compared to aspirin alone in patients with acute ischemic stroke?
Observational (n=70)
No
Does dual antiplatelet therapy with clopidogrel and aspirin improve functional outcomes compared to aspirin alone in patients with acute ischemic stroke?
Absolute Risk Reduction: 1.7 (95% CI 0.03–3.42)
Absolute Event Rate: 17.14% vs 20%
Absolute Risk Reduction: 1.7%
Number Needed to Treat: 59
p-value: p=0.041
Dual antiplatelet therapy with clopidogrel and aspirin significantly reduced poor functional outcomes at 90 days compared to aspirin alone in patients with acute ischemic stroke.
Hypothesis-generating for dual antiplatelet therapy in acute ischemic stroke; leaves open need for randomized confirmation before practice change.
Background: Stroke is a major cause of morbidity and mortality in an aging population. In the elderly, ischemic stroke accounts for more than 80% of all stroke cases. Stroke is the second leading cause of disability after ischaemic heart disease (IHD) and is the sixth leading cause worldwide. The aim of this study was to evaluate the effects of clopidogrel and aspirin (combination therapy) and aspirin alone (monotherapy for Acute Ischemic Stroke patients. Material and Methods: This is a Prospective, non-randomized and observational study conducted in the Department of General Medicine, Subbaiah Institute of Medical Sciences, Shimoga among 70 acute ischemic stroke patients from January 2019 to September 2019. Clopidogrel at an initial dose of 300 mg, followed by 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days) or aspirin (75 mg per day for 90 days) group.Result: In our study, majority of patients were more than 60 years and least were less than 40 years in both the groups. Predominant were male than female in both the groups. An mRS of 3–6 at 90-day assessment occurred in 3 patients in the clopidogrel-aspirin group, and in 3 patients in the aspirin group (p=0.039). Poor quality of life at 90 days occurred in 1 patients in the clopidogrel aspirin group and in 2 in the aspirin group (p=0.081). Conclusions: For patients with acute Acute Ischemic Stroke, treatment with clopidogrel and aspirin provided significantly greater inhibition of platelet activity than aspirin alone. Thus, dual therapy can be safer and more effective in reducing ischemic stroke recurrence.
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S et al. (2020) conducted an observational in Acute Ischemic Stroke (n=70). Clopidogrel and aspirin vs. Aspirin (75 mg/day for 90 days) was evaluated on Dependence or death (mRS 2-6) at 90 days (ARR 1.70%, 95% CI 0.03%-3.42%, p=0.041). In patients with acute ischemic stroke, dual therapy with clopidogrel and aspirin reduced the absolute proportion of poor functional outcome (mRS 2-6) at 90 days by 1.70% compared to aspirin alone.
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