Aspirin-clopidogrel no better than aspirin alone for patients with lacunar stroke

NIH study also shows that overall stroke risk is down from 10 years ago

Nih.gov: Wednesday, August 29, 2012

Aspirin combined with the antiplatelet drug clopidogrel is no better than aspirin alone for stroke prevention in people with a history of lacunar strokes, and the combination carries a greater risk of gastrointestinal bleeding, according to results of a trial funded by the National Institutes of Health. Lacunar strokes occur due to chronic high blood pressure and typically produce small lesions deep within the brain.

The trial results also point to an overall improvement in stroke management during the past decade. Regardless of whether patients received aspirin alone or the dual therapy, their stroke risk was reduced more than three-fold from what it was 10 years ago.

Antiplatelet drugs such as aspirin are routinely prescribed to help prevent new strokes in people with a history of lacunar stroke. The Secondary Prevention of Small Subcortical Strokes (SPS3) trial was designed to determine if adding clopidogrel to aspirin would offer better protection than aspirin alone. The results appear in the Aug. 30th New England Journal of Medicine. They show that the aspirin-clopidogrel combination was about equal to aspirin in reducing the risk of any type of stroke, but it almost doubled the risk of gastrointestinal bleeding. Read More