Clopidogrel-aspirin reduced 90-day stroke recurrence risk by 33% in watershed infarction overall and by 46% in internal WI patients without increasing severe bleeding.
Does clopidogrel-aspirin reduce stroke recurrence compared to aspirin alone in patients with different patterns of watershed infarction?
Dual antiplatelet therapy with clopidogrel and aspirin reduces the risk of stroke recurrence at 90 days in patients with watershed infarction, particularly internal watershed infarction, without increasing moderate-to-severe bleeding.
Absolute Event Rate: 0% vs 0%
Watershed infarction (WI) is heterogeneous. This study aims to explore the effect of clopidogrel-aspirin in patients with WI and which WI patterns could gain more benefits. Patients are classified into cortical WI (CWI) (n = 484), internal WI (IWI) (n = 372), CWI+IWI (n = 410), and non-WI (n = 4,033) according to diffusion-weighted magnetic resonance imaging. The results show that patients with WI treated with clopidogrel-aspirin have a lower risk of stroke recurrence compared to aspirin at 90 days (hazard ratio HR, 0.67; 95% confidence interval CI, 0.49-0.93). Specifically, patients receiving clopidogrel-aspirin show a lower rate of recurrent stroke than those receiving aspirin in IWI (HR, 0.54; 95% CI, 0.30-0.97), and with a similar trend in CWI+IWI, but not significant in CWI (p for interaction = 0.41). Clopidogrel-aspirin does not increase moderate-to-severe bleeding across WI patterns. This study reveals that the effect of clopidogrel-aspirin appears consistent across WI subgroups, but it might be more effective in patients with IWI. This study is registered at Clinicaltrials.gov (NCT03635749).
Pi et al. (Sun,) reported a other. Clopidogrel-aspirin reduced 90-day stroke recurrence risk by 33% in watershed infarction overall and by 46% in internal WI patients without increasing severe bleeding.