Clopidogrel Plus 21 Days of Aspirin Is Superior to Aspirin Alone Within First 24 Hours of TIA or Minor Stroke
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Am Fam Physician. 2014 Jan 1;89(1):55.
Does adding clopidogrel (Plavix) improve outcomes over aspirin alone in the early treatment of transient ischemic attack (TIA) or minor stroke?
Patients with minor stroke (National Institutes of Health [NIH] Stroke Scale score ≤ 3) or TIA have a decreased risk of recurrent stroke if given aspirin plus clopidogrel vs. aspirin alone if started within 24 hours of the onset of symptoms. There was no significant increase in the risk of bleeding events, and other cardiovascular outcomes were not affected. (Level of Evidence = 1b)
The researchers screened 41,561 patients with stroke or TIA at 114 clinical sites in China, and ultimately included 5,170 patients in the study. Inclusion criteria were as follows: 40 years or older, acute minor ischemic stroke or TIA, and an initial treatment given within 24 hours of symptom onset. Patients with low-risk TIAs (ABCD2 score < 3 points) were excluded. Patients with
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