A study published on Wednesday in The New England Journal of Medicine showed that taking the clot-preventing drug clopidogrel with aspirin may lower one’s risk of having a major stroke within the next 90 days following a minor stroke.
An international study of 4,881 adults in 10 countries who either had a minor stroke or a Transient Ischemic Stroke (TIA) showed that people who took clopidogrel plus aspirin had a 25 per cent lower risk of a major stroke, heart attack or death from blood clots within the three months after the first incident, compared with those who took aspirin alone.
“The study gives us solid evidence that we can use this drug combination to prevent strokes in the highest-risk people, but not without some risk of bleeding,” said the paper’s lead author Clay Johnston, professor of neurology at Dell Medical School at the University of Texas at Austin.
Both a minor stroke and TIA are warning signs that a person has a three to fifteen percent chance of having a more severe stroke within the next three months.
A minor stroke is one that results in mild, non-disablin symptoms.
TIA, often called a warning stroke or mini-stroke, is caused by a temporary blockage in a blood vessel to the brain that often dissolves or dislodges on its own to stop symptoms.
But the study also showed a small increase in the risk of a hemorrhage in the clopidogrel-aspirin group compared with the aspirin alone group.
For every 1,000 patients treated with the combination, an extra five major bleeds would be expected but with 15 fewer strokes and other major ischemic events. Because the bleeding events are generally reversible, the overall benefit outweighs the risk for most patients, Johnston said.
“It’s likely we will see more patients who have had a TIA or a minor stroke receiving the combination of clopidogrel and aspirin in the future,” Johnston said.
Clopidogrel, also known as Plavix, is a platelet inhibitor commonly prescribed to people who have peripheral artery disease or who have had a recent heart attack or stroke to prevent future cardiac or stroke events.