Two drugs better than one to prevent small strokes from growing

By ACSH Staff — Jun 27, 2013
ER Stroke

ER Stroke

A new study out of China, published in the New England Journal of Medicine, shows that treating patients with early stroke or Transient Ischemic Attack (TIA, stroke that resolves within a few hours after onset) with two anti-clotting drugs prevents more subsequent major strokes than using just one drug alone.

The authors prospectively evaluated over 5,000 patients at 114 medical centers in China. The subjects, all of whom had presented to the ER with signs of a minor stroke or had a stroke which resolved a TIA were randomly divided into two groups: one group was treated with only aspirin, a known anti-platelet agent, while the other group got aspirin and clopidogrel (Plavix). The patients all began treatment within the first 24 hours of the onset of symptoms.

Over the course of the 90-day follow-up, the aspirin only patients had a major stroke rate of 11.7 percent, while the two-drug group suffered strokes at the rate of 8.2 percent: a 32 percent reduction in this feared and often-fatal outcome. Moreover, the most important side-effect of any anti-platelet or other anti-clotting agent bleeding did not occur more often in the two-drug group.

ACSH s Dr. Gilbert Ross believes this to be an important and well-done study: The problem of reducing the toll of stroke is very important for numerous reasons: it is one of the top-ten causes of death in America. But even worse in some ways, a stroke victim who survives is often left quite handicapped, dependent, and with major speech impairments. Earlier double-drug treatment of these type of warning strokes is now seen to reduce the frequency of progression to major stroke. Previous studies have also shown that even completed, major strokes can have their devastating outcomes reduced with early drug intervention, as long as blood-thinners are given within the first six hours or so.

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