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(HealthDay Information) — Mixed clopidogrel-aspirin remedy initiated inside 72 hours after stroke onset results in decrease threat for brand new stroke at 90 days amongst sufferers with delicate ischemic stroke or high-risk transient ischemic assault (TIA) of presumed atherosclerotic trigger, in response to a examine revealed within the Dec. 28 situation of the New England Journal of Medication.
Ying Gao, MD, from Beijing Tiantan Hospital, and colleagues performed a randomized two-by-two factorial trial involving sufferers with delicate ischemic stroke or high-risk TIA of presumed atherosclerotic trigger who had not undergone thrombosis or thrombectomy. Sufferers had been randomly assigned to obtain clopidogrel plus aspirin or matching clopidogrel placebo plus aspirin in a 1:1 ratio inside 72 hours after symptom onset (3,050 in every group).
The researchers discovered that 7.3 and 9.2% of sufferers within the clopidogrel-aspirin group and aspirin group, respectively, had a brand new stroke at 90 days (hazard ratio, 0.79). Average-to-severe bleeding occurred in 0.9 and 0.4% of sufferers within the clopidogrel-aspirin and aspirin teams, respectively (hazard ratio, 2.08).
“The present trial offers proof to help increasing the time window for twin antiplatelet remedy to 72 hours,” writes the writer of an accompanying editorial. “This timing ought to nonetheless be interpreted as ‘as quickly as doable, however inside 72 hours’ and nonetheless necessitates a loading dose of clopidogrel, since its omission can be akin to delaying remedy.”
The examine was partially funded by Sanofi and Beijing Jialin Pharmaceutical.
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