Key result
Triple antiplatelet therapy shows no proven benefit over guideline care in acute ischemic stroke or TIA.
Why the study?
The optimum choice and number of antithrombotic drugs immediately following stroke to minimize recurrence risk while balancing bleeding risk are unclear.
Triple antiplatelet therapy confers no efficacy advantage yet raises bleeding risk after acute stroke; leaves open optimal short-term regimens for future trials.
Antithrombotic therapy immediately following stroke is important to minimise the risk of recurrence, but the optimum choice and number of drugs to use are unclear, and efficacy in preventing thrombosis needs to be weighed against bleeding risk. In The Lancet, the TARDIS investigators report findings from a randomised trial1 that tested intensive antiplatelet therapy with three agents (aspirin, clopidogrel, and dipyridamole) against therapy based on current UK guidelines2 (either clopidogrel, or aspirin plus dipyridamole) for 30 days in patients with transient ischaemic attack (TIA) or ischaemic stroke.
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Pierre Amarenco (2017) conducted an editorial in Transient ischaemic attack (TIA) or ischaemic stroke. Intensive antiplatelet therapy (aspirin, clopidogrel, and dipyridamole) vs. Guideline-based therapy (clopidogrel, or aspirin plus dipyridamole) was evaluated. The TARDIS randomized trial evaluated intensive antiplatelet therapy with three agents versus standard UK guideline-based therapy for 30 days in patients with TIA or ischemic stroke.
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