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Drug Combo May Reduce Risk of Second Stroke: Study

After small or mini-stroke, aspirin plus Plavix tied to lower odds of another event


This three-month period is the most critical for repeat strokes, with 10 percent to 20 percent of people who have a TIA or minor stroke suffering a second stroke, the researchers said.

Within three months of starting the study, 8.2 percent of the patients taking the two-drug combo had another stroke, compared with 11.7 percent of those taking aspirin alone, the researchers found.

Dr. Rafael Alexander Ortiz, director of neuro-endovascular surgery and stroke at Lenox Hill Hospital in New York City, said these findings are important and, if confirmed, will change standard practice for some stroke patients.

"This is great news in terms of a positive outcome," said Ortiz, who was not involved with the study.

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."

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