The Drug Combo that Could Reduce Stroke Risk

Clopidogrel and low dose aspirin reduced stroke risk

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Many drugs that prevent blood clots are used to reduce stroke risk, but which therapies are the most effective?

A recent review of previous trials examined which combination of drugs was tied to the greatest reduction in stroke numbers.

Researchers found that a dual therapy consisting of clopidogrel (brand name Plavix) and low-dose aspirin significantly reduced the risk of stroke among heart disease patients and stroke survivors.

"Talk to your doctor about preventing a stroke."

Jolanta Siller-Matula, MD, PhD, of the Department of Cardiology in Medical University Vienna, led the review on antiplatelet drugs.

Antiplatelets are drugs used to prevent blood clots.

This review looked at the use of antiplatelets for preventing stroke, which occurs when blood flow to the brain stops and is frequently caused by a blood clot.

The researchers examined 22 trials on stroke risk reduction using antiplatelets. In total, 173,371 patients with heart disease participated in the trials.

The authors of the review looked for prevention of stroke in patients who had and had not had a previous stroke (primary and secondary prevention).

Two trials with 20,232 patients were used to compare aspirin with the antiplatelet clopidogrel.

5.5 percent of the clopidogrel group and 6.0 percent of the aspirin group experienced strokes.

The authors of the review determined that clopidogrel did not significantly reduce stroke risk more than aspirin for both the primary and secondary prevention groups.

Ten trials involving 93,405 participants reported the effects of a dual therapy with clopidogrel and aspirin compared to use of aspirin alone.

In this analysis, 1.8 percent of the dual therapy and 2.2 percent of the aspirin monotherapy group experienced a stroke within 12 months of follow up.

Among 13,237 patients who had already survived a previous stroke, 7 percent of the dual therapy group and 9.2 percent of the aspirin-only therapy group experienced a recurrent stroke.

The researchers found that the dual therapy reduced the risk of stroke by 20 percent compared to aspirin alone for people who did not have a stroke history.

For stroke survivors, the drugs reduced stroke risk by 24 percent compared to aspirin alone.

Additionally, the dual therapy was not tied to an increased risk of bleeding within the skull.

The researchers also examined studies comparing a dual therapy of aspirin and clopidogrel with a dual therapy of aspirin and other types of antiplatelets, prasugrel (brand name Effient) and ticagrelor (brand name Brilinta).

The researchers found that pairing aspirin with prasugrel or ticagrelor did not reduce the risk of stroke any more than aspirin and clopidogrel.

The authors of the review concluded that low-dose aspirin paired with clopidogrel may prevent stroke among people with heart disease.

The study was published in Stroke on December 27.

Several researchers disclosed financial relationships with pharmaceutical companies. The authors did not disclose funding sources.

Review Date: 
December 30, 2013
Last Updated:
December 31, 2013