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After Minor Stroke, Adding Clopidogrel to Aspirin Reduces Further Risk in Some — Physician’s First Watch
After Minor Stroke, Adding Clopidogrel to Aspirin Reduces Further Risk in Some
By Joe Elia
Patients taking clopidogrel in addition to aspirin after minor ischemic stroke show a lower risk for early recurrence, according to a New England Journal of Medicine study. An editorialist says the results apply mostly to Chinese patients on the basis of current evidence.
In a multicenter study, researchers randomized some 5200 Chinese patients within 24 hours after symptoms of minor ischemic stroke or high-risk transient ischemic attack. Half were assigned to 90 days of clopidogrel, plus aspirin for the first 21 days; the other half received aspirin plus placebo for 90 days.
During the 90 days, stroke occurred in 8.2% of the clopidogrel-plus-aspirin group, versus 11.7% of the aspirin-alone group. Moderate or severe hemorrhage (the study's primary safety outcome) occurred in 0.3% of each group.
An editorialist writes that Chinese patients with these symptoms "should be regarded as a medical emergency" and should be given the clopidogrel-plus-aspirin regimen.