Drug Combo May Reduce Risk of Second Stroke: Study
After small or mini-stroke, aspirin plus Plavix tied to lower odds of another event
Recently, doctors have moved away from using this combination of drugs for long-term stroke treatment because of the increased risk of serious bleeding, he said.
"Now we can see there is a definite benefit of the combined use of aspirin and Plavix in the acute phase of stroke," Ortiz said.
He said this treatment appears most effective in patients who have suffered a minor stroke or TIA. "If the results of other trials are similar to what we saw in this one, more people will use this therapy," he said. "It offers more tools and better options to offer patients."
Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine, said the study "provides some very convincing data on the efficacy of clopidogrel and aspirin in the acute phases after TIA or minor stroke compared to aspirin among Chinese patients." He also noted that TIA patients are at a high risk for stroke.
Sacco said that in previous studies, the drug combination has not been found effective in long-term treatment to prevent a second stroke. However, he added, "this trial offers hope that in the short term, combination [drugs] may be worth the increased bleeding risk to improve outcomes."
He mentioned current studies that "continue to assess this more aggressive [combination drug] option among U.S. patients, since Chinese patients could have different stroke subtypes and higher risks of recurrence."
Study author Johnston acknowledged that his later U.S. trial is important because differences in genetics, risk factors and medical practice in China could mean different results for different countries.
If in a few years the U.S. results turn out the same as those of the China-based study, giving stroke and TIA patients Plavix along with aspirin will likely become standard therapy, he said.
Stroke is a major cause of death and disability around the world, and the fourth leading cause of death in the United States.
More than 795,000 Americans have strokes every year, and in 2008 some 133,000 were fatal, according to the U.S. Centers for Disease Control and Prevention. In addition, about 300,000 Americans have TIAs each year.