Key result
Dual antiplatelet therapy demonstrated benefit over monotherapy for acute non-cardioembolic ischemic stroke or TIA, but limitations preclude changing the standard approach.
Why the study?
Does early dual antiplatelet therapy reduce recurrent stroke, myocardial infarction and cardiovascular death in patients with acute non-cardioembolic ischaemic stroke or transient ischaemic attack?
Does early dual antiplatelet therapy reduce recurrent stroke, myocardial infarction and cardiovascular death in patients with acute non-cardioembolic ischaemic stroke or transient ischaemic attack?
While a meta-analysis suggests benefit for dual antiplatelet therapy in acute non-cardioembolic ischemic stroke or TIA, limitations preclude changing the standard mono antiplatelet therapy approach.
Commentary on: Wong KSL, Wang Y, Leng X, et al. Early dual versus mono antiplatelet therapy for acute non-cardioembolic ischemic stroke or transient ischemic attack. An updated systematic review and meta-analysis. Circulation 2013;128:1656–66.[OpenUrl][1][Abstract/FREE Full Text][2] Current guidelines recommend aspirin, aspirin plus clopidogrel or aspirin plus extended-release dipyridamole for treatment of acute ischaemic stroke (IS) or transient ischaemic attack (TIA) to prevent recurrent stroke, myocardial infarction and cardiovascular death.1 The Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial randomised 5170 Chinese patients within 24 h after the onset of IS or TIA to clopidogrel plus aspirin versus aspirin plus placebo for 90 days. Clopidogrel plus … [1]: {openurl}?query=rft.jtitle%253DCirculation%26rft_id%253Dinfo%253Adoi%252F10.1161%252FCIRCULATIONAHA.113.003187%26rft_id%253Dinfo%253Apmid%252F24030500%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=circulationaha&resid=128/15/1656&atom=%2Febmed%2F19%2F3%2F94.atom
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Wilbert S. Aronow (2014) conducted an editorial in acute non-cardioembolic ischaemic stroke or transient ischaemic attack (n=5,170). clopidogrel plus aspirin vs. aspirin plus placebo was evaluated. Dual antiplatelet therapy demonstrated benefit over monotherapy for acute non-cardioembolic ischemic stroke or TIA, but limitations preclude changing the standard approach.
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