Combination antiplatelet therapy ruled out in small subcortical stroke

MedWire News: The combination of clopidogrel and aspirin does not help, and may harm, patients with small subcortical stroke, show findings from the antiplatelet arm of the SPS3 trial.

Patients given combination treatment had as many strokes as those given aspirin alone, and also had more bleeding events and were more likely to die during follow up, the investigators reported at the International Stroke Conference in New Orleans, Louisiana, USA.

The SPS3 (Secondary Prevention of Small Subcortical Stroke) trial was designed to simultaneously test two interventions in patients with a lacunar stroke within the previous 180 days.

The 3020 patients in the trial were randomly assigned to receive aspirin 325 mg/day plus either clopidogrel 75 mg/day or placebo in a double-blind fashion, and to receive open-label treatment of blood pressure to the “usual” systolic target of 130-149 mmHg or to an intensive target of less than 130 mmHg.

The antiplatelet intervention was stopped prematurely for futility and due to safety concerns, whereas the blood pressure intervention will continue until April this year. Read Full Article