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Stroke Health Center

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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

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, June 26 (HealthDay News) -- After suffering a stroke or a mini-stroke, patients are usually given aspirin to prevent clots that can cause another stroke. Now a new study suggests that adding the drug Plavix (clopidogrel) to the mix can reduce the risk of a second stroke by nearly a third over aspirin alone.

Both drugs target clotting agents in the blood, called platelets, preventing them from grouping together and forming clots. The drug combination is commonly used after a heart attack, but until now there hasn't been enough data to suggest it would work in stroke or mini-stroke, officially known as a transient ischemic attack (TIA).

"Giving two drugs that block platelets works a lot better than aspirin alone in people who have had a minor stroke or TIA," said researcher Dr. S. Claiborne Johnston, a professor of neurology at the University of California, San Francisco.

The trial was done in China, so whether the results would be the same in the United States isn't known. "They probably are, but we would like to see them confirmed," Johnston said.

To do so, a similar trial is under way in the United States with Johnston as the lead investigator. "We should have confirmation or no confirmation within a few years," he said.

Some doctors are treating stroke patients with this combination of drugs now, Johnston said. "This combination may be something [other] doctors can consider," he said.

The report was published June 26 in the online edition of the New England Journal of Medicine.

Most strokes are caused by blood clots that block blood vessels in the brain. These are called ischemic strokes. A TIA is also caused by a clot that dissipates in a short time. Both leave patients at risk for another stroke that could be more severe, the researchers said.

In the new phase 3 trial, more than 5,000 patients who had suffered a stroke or TIA within the previous 24 hours were randomly assigned to take either aspirin alone or aspirin plus Plavix for three months.

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