August 1, 1991
View Full PaperThe European Stroke Prevention Study
Key Result
A combination of dipyridamole and acetylsalicylic acid significantly reduced the risk of stroke or death compared to placebo in patients with recent TIA or stroke.
Study Design
Type
RCT (n=2,500)
Multicenter
Yes
Structured PICO
Does a combination of dipyridamole and acetylsalicylic acid reduce stroke or death in patients with recent transient ischemic attacks or atherothrombotic stroke?
P
Population
2,500 patients with recent transient ischemic attacks or stroke of atherothrombotic origin.
I
Intervention
Combination of 75 mg dipyridamole and 330 mg acetylsalicylic acid tid (three times daily)
C
Comparator
Placebo
O
Outcome
Stroke or deathhard clinical
Combination antiplatelet therapy with dipyridamole and acetylsalicylic acid effectively reduces the risk of stroke or death in both men and women with recent TIA or atherothrombotic stroke.
Main Result
Effect estimate: 39% risk reduction in men, 30% risk reduction in women
Abstract
The European Stroke Prevention Study was a multicenter trial comparing the effect of a combination of 75 mg dipyridamole and 330 mg acetylsalicylic acid tid with placebo in the prevention of stroke or death after one or more attacks of recent transient ischemic attacks or stroke of atherothrombotic origin. From the 2,500 patients in the intention-to-treat analysis, the proportion of women was 42%, and from the 1,861 patients in the explanatory analysis it was 44%. The endpoint incidence was significantly higher in men than in women. The endpoint reduction was statistically significant only in the intention-to-treat analysis with total endpoints. However, there was a marked percentage reduction of endpoints in both men and women in explanatory analysis. The risk reduction of strokes was 49% for men and 41% for women, and the reduction of total endpoints was 39% in men and 30% in women. Thus, antiplatelet therapy is effective in the prevention of stroke or death in both sexes.