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Stroke

A new CHANCE for combination antiplatelet therapy?

Nature Reviews Neurology volume 9, pages 549–550 (2013)Cite this article

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Patients with transient ischaemic attack or minor ischaemic stroke have a high risk of early recurrence. A new study in Chinese patients suggests that this risk is reduced following treatment with clopidogrel plus aspirin compared with aspirin alone. However, whether the findings can be extrapolated to other populations remains unclear.

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References

  1. Wang, Y. et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N. Engl. J. Med. 369, 11–19 (2013).

    Article  CAS  Google Scholar 

  2. Rosemary, J. & Adithan, C. The pharmacogenetics of CYP2C9 and CYP2C19: ethnic variation and clinical significance. Curr. Clin. Pharmacol. 2, 93–109 (2007).

    Article  CAS  Google Scholar 

  3. Palacio, S. et al. Effect of addition of clopidogrel to aspirin on stroke incidence: meta-analysis of randomized trials. Int. J. Stroke http://dx.doi.org/10.1111/ijs.12050.

  4. Geeganage, C. M. et al. Dual or mono antiplatelet therapy for patients with acute ischemic stroke or transient ischemic attack: systematic review and meta-analysis of randomized controlled trials. Stroke 43, 1058–1066 (2012).

    Article  CAS  Google Scholar 

  5. Rothwell, P. M. et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 370, 1432–1442 (2007).

    Article  Google Scholar 

  6. Lavallee, P. C. et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol. 6, 953–960 (2007).

    Article  CAS  Google Scholar 

  7. Diener, H. et al. Acetylsalicylic acid on a background of clopidogrel in high-risk patients randomised after recent ischaemic stroke or transient ischaemic attack: the MATCH trial results. Lancet 364, 331–334 (2004).

    Article  CAS  Google Scholar 

  8. Bhatt, D. L. et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N. Engl. J. Med. 354, 1706–1717 (2006).

    Article  CAS  Google Scholar 

  9. SPS3 Investigators. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N. Engl. J. Med. 367, 817–825 (2012).

  10. Markus, H. S. et al. Dual antiplatelet therapy with clopidogrel and aspirin in symptomatic carotid stenosis evaluated using Doppler embolic signal detection: the Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic Carotid Stenosis (CARESS) trial. Circulation 111, 2233–2240 (2005).

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Neurology and Stroke Centre, University Duisburg-Essen, Hufelandstrasse 55, Essen, 45147, Germany

    Hans-Christoph Diener & Christian Weimar

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  1. Hans-Christoph Diener
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  2. Christian Weimar
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Correspondence to Hans-Christoph Diener.

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Competing interests

H.-C. Diener has received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from: Abbott, Allergan, AstraZeneca, Bayer Vital, BMS, Boehringer Ingelheim, CoAxia, Corimmun, Covidien, Daichii-Sankyo, D Pharm, EV3, Fresenius, GlaxoSmithKline, Janssen Cilag, Johnson & Johnson, Knoll, MSD, Medtronic, MindFrame, Neurobiological Technologies, Novartis, Novo-Nordisk, Paion, Parke-Davis, Pfizer, Sanofi-Aventis, Schering-Plough, Servier, Solvay, Thrombogenics, Wyeth and Yamanouchi. Financial support for research projects was provided by AstraZeneca, GlaxoSmithKline, Boehringer Ingelheim, Lundbeck, Novartis, Janssen Cilag, Sanofi-Aventis, Syngis and Talecris. He was the Principal Investigator (PI) of the ESPS 2 and MATCH trials, and Co-PI of the PRoFESS trial. Dr Diener has no ownership interest and does not own stocks of any pharmaceutical company.

C. Weimar has received honoraria for participation in clinical trials, contribution to advisory boards, oral presentations or travel support from: Bayer, Biogen, Boehringer Ingelheim, Brainsgate, Bristol-Myers Squib, Co-Axia, D Pharm, Photothera, Sanofi-Aventis, Syngis, Teva, Thrombogenics. He receives project funding from Johnson & Johnson.

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Diener, HC., Weimar, C. A new CHANCE for combination antiplatelet therapy?. Nat Rev Neurol 9, 549–550 (2013). https://doi.org/10.1038/nrneurol.2013.191

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