Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA

New England Journal of Medicine

Volumn 379, Issue 3, 2018, Pages 215-225

  Claiborne Johnston, S ^a   Donald Easton, J ^b   Farrant, Mary ^b   Barsan, William ^c   Conwit, Robin A ^d   Elm, Jordan J ^f   Kim, Anthony S ^b   Lindblad, Anne S ^e   Palesch, Yuko Y ^f  

^a UNIVERSITY OF TEXAS AT AUSTIN   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^d NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE   (United States)

^e EMMES   (United States)

^f MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; CLOPIDOGREL; PLACEBO; ANTITHROMBOCYTIC AGENT; TICLOPIDINE;

ADULT; ARTICLE; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CONTROLLED STUDY; DEATH; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG SAFETY; FEMALE; HEART INFARCTION; HUMAN; LOADING DRUG DOSE; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR; TRANSIENT ISCHEMIC ATTACK; TREATMENT DURATION; TREATMENT OUTCOME; AGED; ANALOGS AND DERIVATIVES; BLEEDING; CEREBROVASCULAR ACCIDENT; CHEMICALLY INDUCED; CLINICAL TRIAL; COMBINATION DRUG THERAPY; ISCHEMIA; MIDDLE AGED; MORTALITY; MULTICENTER STUDY; RISK; SECONDARY PREVENTION;

AGED; ASPIRIN; BRAIN ISCHEMIA; DOUBLE-BLIND METHOD; DRUG THERAPY, COMBINATION; FEMALE; HEMORRHAGE; HUMANS; ISCHEMIA; ISCHEMIC ATTACK, TRANSIENT; MALE; MIDDLE AGED; MYOCARDIAL INFARCTION; PLATELET AGGREGATION INHIBITORS; RISK; SECONDARY PREVENTION; STROKE; TICLOPIDINE;

EID: 85050234799     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMoa1800410     Document Type: Article

References (20)

1. Johnston SC, Gress DR, Browner WS, Sidney S. Short-term prognosis after emergency- department diagnosis of transient ischemic attack. JAMA 2000; 284: 2901-2906.
2. Coull AJ, Lovett JK, Rothwell PM. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ 2004; 328: 326.
3. Giles MF, Rothwell PM. Risk of stroke early after transient ischaemic attack: A systematic review and meta-analysis. Lancet Neurol 2007; 6: 1063-1072.
4. Wu CM, McLaughlin K, Lorenzetti DL, Hill MD, Manns BJ, Ghali WA. Early risk of stroke after transient ischemic attack: A systematic review and meta-analysis. Arch Intern Med 2007; 167: 2417-2422.
5. Amarenco P, Lavallee PC, Labreuche J, et al. One-year risk of stroke and major cardiovascular events after transient ischemic attack or minor ischemic stroke. N Engl J Med 2016; 374: 1533-1542.
6. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45: 2160-2236.
7. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71-86.
8. CAST (Chinese Acute Stroke Trial) Collaborative Group. CAST: randomised placebo-controlled trial of early aspirin use in 20, 000 patients with acute ischaemic stroke. Lancet 1997; 349: 1641-1649.
9. International Stroke Trial Collaborative Group. The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet 1997; 349: 1569-1581.
10. Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49(3): e46-e110.
11. Bowry AD, Brookhart MA, Choudhry NK. Meta-analysis of the efficacy and safety of clopidogrel plus aspirin as compared to antiplatelet monotherapy for the prevention of vascular events. Am J Cardiol 2008; 101: 960-266.
12. Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013; 369: 11-19.
13. Johnston SC, Easton JD, Farrant M, et al. Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial: rationale and design. Int J Stroke 2013; 8: 479-483.
14. Johnston SC, Rothwell PM, Nguyen- Huynh MN, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 2007; 369: 283-292.
15. Schulman S, Kearon C, Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in nonsurgical patients. J Thromb Haemost 2005; 3: 692-694.
16. Diener HC, Sacco RL, Yusuf S, et al. Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: A double-blind, active and placebo-controlled study. Lancet Neurol 2008; 7: 875-884.
17. Wang Y, Zhao X, Lin J, et al. Association between CYP2C19 loss-of-function allele status and efficacy of clopidogrel for risk reduction among patients with minor stroke or transient ischemic attack. JAMA 2016; 3t16: 70-78.
18. Johnston SC, Amarenco P, Albers GW, et al. Ticagrelor versus aspirin in acute stroke or transient ischemic attack. N Engl J Med 2016; 375: 35-43.
19. Bath PM, Woodhouse LJ, Appleton JP, et al. Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): A randomised, open-label, phase 3 superiority trial. Lancet 2018; 391: 850-859.
20. Amarenco P, Albers GW, Denison H, et al. Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin: A subgroup analysis of SOCRATES, a randomised, double-blind, controlled trial. Lancet Neurol 2017; 16: 301-310.