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N Engl J Med. 2018 Jul 19;379(3):215-225. doi: 10.1056/NEJMoa1800410. Epub 2018 May 16.

Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA.

Collaborators (2594)

Janis S, Tillman H, Dillon C, Kasperek-Wynn R, Stevenson V, Morgenstern L, Burke C, Jones L, Vogan K, del Zoppo GJ, Cote R, Eliasziw M, Fayad P, Lowe AM, Piña IL, Swain JA, Adelman E, Scott B, Bach D, Duvernoy CS, Kerber KA, Levine DA, Lorincz MT, Zahuranec DB, Black J, Silbergleit R, Speers M, Van Huysen C, Bonham T, Deyampert A, Frederikson S, Mawocha S, Neshewat G, Dillon CR, Khattak F, Patel K, Pauls K, Sirline L, Zhao W, Conner C, Henry A, Perlmutter A, Zurita KG, Biagini T, Contreras MT, Glennon C, Avveduti S, Hebert E, Luther-Lemmon C, Morgan R, Rosborough K, Luce C, McKenna S, Lozano ME, Petrolo S, Levi C, Thijs V, Brodtmann A, Simpson M, Young D, Bladin C, Cameron J, Choi P, Coote S, Dewey H, Gilligan A, Lee S, Muller C, Sien Loh P, Tse G, Zhang W, Ross Z, Thomas G, Wijeratne T, Goff J, Mackey E, Celestino S, Low E, O'Brien B, Caruana P, Crimmins D, Evans JW, Gordon P, Hwang Y, Patel T, Pavey N, Reyneke E, Selby A, Sturm J, Whyte S, Winters S, Alchin D, Rhodes S, Levi C, Spratt N, Ang T, Demeestere J, Esperon C, Krishnamurthy V, Loiselle A, Miteff F, Parsons M, Patel R, Haines T, Kerr E, Kitsos G, Phan T, Clissold B, Ly J, Ma H, Wong K, Kleinig T, Cheong E, Kurunawai C, Cranefield J, Davis S, Campbell B, Chandratheva A, Dharmadasa T, Giles L, Hand P, John N, Lee M, Lynn N, Neal A, Oxley T, Shah D, Tu HT, Vivek V, Wu T, Yan B, Yassi N, Zhao H, McDonald A, Silver G, Coutts S, Shuaib A, Ahmad A, Basir G, Brebesh B, Butt AJ, Das S, D'Souza A, Gajurel B, Ghrooda E, Hussain D, Kalashya H, Kamble Jayaprakash H, Kate M, Kazi SA, Manosalva HA, Parthasarathy R, Thirunavukarasu S, Wassef A, Schwindt B, Al Sultan A, Alseraya A, Blayney S, Chakraborty D, Chen S, Dey S, Dubuc V, Eswaradass P, Field T, Graham B, Hegedus J, Hill M, Imoukhuede O, Klourfeld E, Lockey A, Moussaddy A, Musuka T, Newcommon N, Nikneshan D, Reddy R, Singh D, Singh R, Sitaram A, Teleg E, Tham C, Trivedi A, Van Gaal S, Yu A, Zerna C, Kenney C, Save S, Boulanger JM, Berger L, Blais L, Verreault S, Camden MC, Mackey A, Collard K, Hache A, Buck B, Siddiqui M, Jassal R, Bergquist D, Piquette L, Chan R, Abootalebi S, Alsubaie R, Azarpazhooh R, Fridman S, Khaw A, Mandzia J, Palamarchuk I, Riccio P, Sposato L, Amato-Marziali B, Beauchamp B, Crann S, Hesser K, Lambourn L, Wein T, Ehrensperger E, Vieira L, Wadup L, Odier C, Daneault N, Deschaintre Y, Durocher A, Gioia L, Jacquin G, Lanthier S, Poppe A, Stapf C, Lapierre M, Yip S, Asdaghi N, Benavente O, Gomez Gonzalez A, Honig A, Mann S, Murphy C, Teal P, Wilson L, MacLean G, Murray K, Roine R, Tatlisumak T, Curtze S, Kivioja R, Koivu M, Larjo T, Marinkovic I, Martinez-Majander N, Osterlund-Tauriala E, Shulga A, Sibolt G, Tapanainen A, Tiainen M, Tomppo L, Tumpula O, Vainikka S, Valkonen K, Virta J, Ylikallio E, Eirola S, Aivo J, Bruck A, Hurri L, Jokela M, Korpela J, Roine S, Ruuskanen J, Ylikotila P, Eriksson J, Amarenco P, Obadia M, Fissellier M, Grosliere L, Jouaville S, Perriot E, Pincini A, Tine J, Meseguer E, Cabrejo L, Guidoux C, Hobeanu C, Lavallee P, Martin Bechet A, Rigual R, Begon E, Djedidi L, Philippeau F, Olaru AC, Sosyak T, Lapergue B, Wang A, Lopez D, Nighoghossian N, Benoit A, Cho TH, Derex L, Mechtouff L, Ong E, Buisson M, Samson Y, Baronnet F, Crozier S, Deltour S, Diaz Fernandez B, Le Bouc R, Leger A, Rosso C, Yger M, Aidaoui B, Pires C, Diener HC, Kastrup A, Becker U, Brunner F, Guentner J, Schroter A, Merdivan H, Weissenborn K, Gabriel M, Grosse G, Schuppner R, Worthmann H, Plüschke F, Schaeffer K, von der Haar F, Koehrmann M, Weimar C, Chen HC, Frank B, Hajjar K, Dietzold M, Pfeilschifter W, Bohmann F, Dive I, Filipski K, Foerch C, Kestner RI, Lorenz M, Schaefer JH, Seiler A, Tahtali D, Rai H, Althaus K, Mueller S, Neugebauer H, Stoesser S, Stroh S, Raubold S, Thomalla G, Beck C, Cheng B, Golsari A, Hoppe J, Krutzelmann AC, Schroeder J, Voget D, Otto D, Villarreal-Careaga J, Lopez Meza EG, Altamirano Beltran KG, Perez Coronel C, Lopez Meza W, Barber PA, Anderson N, Brennan M, Jenkins N, Kao J, Tse D, Zhao L, Molina C, Martí-Fàbregas J, Aracil-Bolaños I, Camps-Renom P, Delgado-Mederos R, Figueroa S, Guisado-Alonso D, Martínez-Domeño A, Prats-Sánchez L, Simón-Talero M, Sotoca J, Marín R, Freijo Guerrero MM, Aguilera B, Auzmendi L, Fernandez JM, Gil Alzueta MC, Gonzalez S, Idro JL, Ikerne A, Lorenzo Garcia AM, Sainz A, Silvarrey Rodriguez S, Garcia Sanchez JM, Bravo Anguiano Y, Bartulos Iglesias M, Pascual Carrascal D, Rodrigues Peguero FJ, Trejo Gabriel y Galan JM, Castellanos Rodrigo MM, Serena J, Alemany Perna B, Bashir S, Bragado I, Coll C, Cots A, Irida Lloret Villas M, Marquez F, Silva Y, Terceno M, Uscamaita KE, Van Eendenburg C, Jordan B, Kazimierczak M, Pardo L, Roquer J, Cuadrado E, Giralt E, Jimenez Conde J, Ois A, Rodriguez A, Vivanco R, Romeral G, de Arce Borda AM, Diez Gonzalez N, Gonzalez Lopez F, Martinez Pineiro MB, Martinez Zabaleta MT, Tainta Cuezva M, Zulaica Ijurco M, Lago A, Fortea G, Lopez R, Morales-Caba L, Tembl JI, Sahuquillo P, Marta-Moreno J, Artal J, Caldu R, Fernández A, Seral-Moral M, Serrano M, Tejada Meza H, Boned S, Juega J, Muchada M, Rodriguez N, Sanjuan E, Kennedy J, Khadjooi K, Chandrasena D, Crisp S, Evans N, Fiddes B, Hannon N, Hayden D, Hayhoe H, Kelly S, O'Brien E, Warburton E, Amis E, Farron C, Mitchell J, Ford G, Mathieson P, Mazzucco S, Pope G, Reckless I, Schulz U, Shah K, Teal R, Sekaran L, Alwis L, Mohammad N, Philippanathan J, Phiri D, Sethuraman S, Tate M, Cohen D, Abdul-Saheb M, Bathula R, Devine J, Doubravska S, Licenik R, Ngwako M, Nisar N, Sivagnanaratnam A, Mpelembue M, Muir K, Cheripelli B, Elliot J, Huang X, Kalladka D, Moreton F, Ramachandran S, El Tawil S, Smith W, Natarajan I, Chembala J, Roffe C, Sanyal R, Warusevitane A, Weerathunga J, Carpio R, Gbadamoshi L, Choulerton J, Dow L, Newton H, Shaw L, Stone A, Avis J, Lucas S, Madigan B, Weir N, Crawford P, Evans S, Marigold J, Wood E, Gartrell I, Smith S, Perry R, Banergee G, Wilson D, Banaras A, Watchurst C, Sethi P, Xu J, Yan Y, Sabir R, Dietrich D, Henning W, Armstrong L, Casey M, Schaefer V, Ching M, Deline C, Kandel A, Sawyer R, Crumlish A, Holler DL, Chiu D, Bledsoe D, Gadhia R, Imperial-Aubin D, Lee JA, McCane D, Misra V, Mistry E, Moye S, Rahman H, Thomas A, Volpi J, White S, Alberts M, Bernstein R, Caprio F, Chang P, Lin C, Mendelson S, Prabhakaran S, Ruff Treiber I, Muskovich K, Wymore E, Katzan I, Al-Masry M, Buletko A, Cardona L, Cerejo R, Cheng-Ching E, Farrag A, George P, Hussain S, Itrat A, John S, Khawaja Z, Lu M, Man S, Mathew J, Morton J, Mullaguri N, Russman A, Shankar L, Sheikhi L, Taqui A, Thacker T, Toth G, Uchino K, Wasielewski P, Wisco D, Bynum E, Puvenna V, Richmond A, Tighe N, Meyer D, Agrawal K, Ali M, Attenhofer K, Bruce N, Choe J, Claycomb R, Guzik A, Hailey L, Hemmen T, Herial N, Ho J, Huisa B, Loc K, Lunagariya A, Meyer B, Modir R, Mortin M, Narula R, Neil W, Nguyen D, Ovbiagele B, Pirastehfar M, Ramani H, Sadikovic B, Schlick K, Selvan P, Sodhi A, Kelly N, Lehmann B, Rapp K, Rickes K, Woods K, Marden F, Bey M, Gorelick P, Harrison C, Patel A, Raimondi A, Reilly G, Reiss M, Sherman S, Terna T, Fox E, Hefzy H, Tayal A, Bremner B, Gettings E, Hammad O, Jarouse J, Marynowski M, O'Neill J, Ramanathan R, Shah L, Venkat A, Wong C, Wright D, Chauhan V, Love G, Tian M, McMahon R, Gildersleeve R, Cutlip R, Switzer J, Afzal F, Aryal T, Bruno A, Gross H, Hess D, Nichols F, Saler M, Stewart S, Wees N, Bishop N, Christensen E, Close B, Jacob S, Jordan J, Massenberg T, Williams K, Ng CK, Sangha A, Angeli D, Asghar M, Epps S, Campbell A, Grubbs B, Harris L, Lane P, Schulman A, Boyce M, Cohen R, Donaldson R, Edmonson S, Hardy D, Harris K, McGee F, O'Bannon J, Ransom M, Rehman N, Smith T, Stucki B, White R, Wittman J, Kinnie I, Walthour T, Kase CS, Romero JR, Aparicio H, Babikian V, Greer D, Nguyen T, Abbas S, Lau H, Ogrodnik M, Iyengar P, Iyer S, Asimos A, Chaconas A, Giordano J, Hoyt A, Patel S, Stevens D, Traynor M, Brandon N, Dailey A, Kramer M, Price M, Robinson B, Song S, Dumitrascu O, Le D, Lyden P, Mayorbasto F, Nezhad M, Shafie M, Shek Y, Kim PC, Palikh G, Edwards R, Reynolds A, Lukovits T, Clark-Arbogast R, Goddeau R, Johns J, Renga V, Rojas-Soto D, Jeffreys C, Notestine M, Arangua L, Taqi MA, Fischberg GM, Kong XT, Nik A, Salahuddin T, Tarlov N, Khan Y, Labib Namin-Reza Salari B, Faheim M, Kamel K, Labib D, Tang K, Dinar A, Gomez F, Panetta M, Dafer R, Ong A, Gil F, Lynch D, Meyers S, Munson R, Anderson J, Loeb S, Maher ML, Rouse SD, Gorman M, Commichau C, Gregory C, Kenney S, Chase C, Anyanwu B, Bathory T, Burke P, Campbell A, Campbell B, Dakakni T, Heath V, Kraft H, Melvin E, Onasanya O, Stewart C, Norwood D, Tirschwell D, Becker K, Creutzfeldt C, Kalani R, Kay M, Khot S, Longstreth W, Schepp S, Weinstein J, Kunze A, Schubert G, Tanzi P, McCullough L, Hosley C, Sansing L, Silverman I, Ahlquist M, Harris G, Thurston S, Johnson M, Burrus T, Abdoush P, Galicia C, Berndt L, Rappard N, Yilmaz E, Fuller T, Lawrence D, Martino S, Deutsch A, Fitzpatrick J, Gilson P, Kostoulakos P, Sedarous M, Spellman E, Collins F, Detoro A, Ortiz J, Kirmani J, Panezai S, Brar J, Korya D, Kulhari A, Mehta S, Moussavi M, Patel A, Singh A, Strauss S, deCarvalho B, Stephens R, Gillum L, Schadendorf S, Stephens J, Algar R, Holtz S, Lin J, Volpi B, Ajani Z, Ford S, Manthena P, Sangha N, Sevilis T, Sofroni E, Flores N, Kim R, Lui C, Sobhawongse V, Tu G, Turner K, Valdovinos C, Castaldo J, Zhang FC, Clauser G, Edwards A, El-Hunjul M, Isayev Y, Leary M, Li Y, Mehta D, Melinosky C, Reichenbach K, Schumacher H, Spikol L, Varrato J, Yacoub H, Fox C, Hartman L, Kloiber T, Nabhan S, Suriya S, Schneck M, Biller J, Millsap L, Morales-Vidal S, Bernier T, Chadwick L, Prodoehl K, Rudolph S, Law S, Rabinovich A, Morhaim H, McElveen WA, Besen J, Gonzalez R, Emmert L, Marino E, Roman V, Aguilar M, Capampangan D, Demaerschalk B, Dodick D, Ingall T, Kiernan T, Lee-Iannotti J, Vargas B, Yancy H, Boyd E, Farooq M, Goshgarian C, Groenhout A, Haveman-Gould B, Min J, Smith SL, Duff RS, Crouse E, Medley R, Ramirez-Abreu D, Thompson L, Jensen J, Logan W, Donohoo M, Green B, Rempe D, Wilcox M, Kramer J, Vaughan S, Davis AL, Martin E, Ionita C, Guterman L, Heyden A, Lee-Kwen P, Pereira L, Conover C, Duane S, Ernst N, Parkes K, Hanna J, Bahntge M, Garber B, Schrock J, Werner S, Winkelman M, Cook D, Jacobs B, Braunlin J, Fathy A, Kitchener J, Ludwig B, Marriott E, Snider R, Terry J, Shoen A, Taylor R, Benton C, Jones R, Larson J, Larson S, Leacock R, Perkins M, Schneider A, Wisham NM, Nanney T, Chong J, Brockington C, Fory E, Nasrallah J, Tegtmeyer C, Bonilla L, Harris I, Liebeskind D, Patterson S, Hartung R, Todo A, Dwyer J, Velikovic M, Bellantoni J, Rubin M, Navi B, Clark S, Crimmins M, Czeisler B, Dangayach N, Dubow J, Fink M, Foreman B, Ganzman A, Jamieson D, Kamel H, Kummer B, Lappin R, Leifer D, Lerario M, Mangla A, Mir S, Pishanidar S, Sacchetti D, Safdieh J, Segal A, Sevush J, Sharma R, Weathered N, White H, Zammit C, Zhang Y, Mathias R, Nikolov B, Xhori E, Behrouz R, Torbey M, Gough B, Greene-Chandos D, Grose N, Gulati D, Hussein O, Mainali S, Slivka A, Woodling K, Agriesti J, Buchwalder L, Koch S, Tariq A, Sen S, Androulakis XM, Faber T, Gerard B, Hammett D, Herath P, Hwang TL, Mehta S, Mrelashvili D, Piriyawat P, Selph J, Venkatesh S, Hall K, Kennedy E, Laird S, Davenport J, Ostrander M, Melvin K, Martin D, Johnson M, Banerjee C, Hansen P, Haralur Sreekantaiah Y, Hasan R, Lee J, Magadan A, Shang T, Siddiqui F, Warnack W, Cameron-Watts J, Gathua N, Chang FL, Al Hamda A, Banas T, Bhat M, Bultemeyer M, Curfman T, Gupta A, Khan A, Knirk J, Later P, Mueller-Kronast N, Stevens J, Budzon S, Carol J, Reichwein R, Aucutt-Walter N, Bettermann K, El-Ghanem M, Emmady P, Ermak D, Fischer M, Gardner K, Good D, Ibrahimi M, Leaming J, Hitz K, Badruddin A, Asif K, Chen S, Johansen J, Pandya D, McLennan L, Paganessi L, Kansara A, Belling C, Bhatt A, Caceres CD, Clark D, Dancer S, Dhillon A, Freeman B, Judd L, Lowenkopf T, McClenathan B, Prince P, Robison J, Rontal A, Sampson T, Sapkota B, Scheibe-Mirek T, Yanase L, Zurasky J, Johnson E, Larsen D, Young A, Zerizef C, Geraghty M, Al-Hafian K, Rawner E, Aaron B, Cantrell T, Burgin S, Matmati K, Burdette J, Job C, Maher T, McIntosh C, Samkoff L, Schindler K, Weber C, Starkman S, Abcede L, Adamczyk P, Arch A, Bahrhosseini M, Calderon-Arnulphi M, Chhabra A, Fan CF, Frischmann L, Gaines N, Hinman J, Huang J, Kim D, Liang C, Malhotra K, Maluste N, McManus M, Ng K, Noorian A, Nour M, Ramirez L, Rao N, Raychev R, Reider-Demer M, Saver J, Sharma L, Sheth S, Singh P, Song S, Tang X, Tansy A, Tarpley J, Tipirneni A, Yallapragada A, Grunberg I, Guzy J, Haskins D, Mehta D, Roe K, Kaminski M, Fallis R, Fleming J, Lafranchise F, Prasad S, Upchurch T, Coman D, Payne M, Qazi F, Rosenthal J, Sood S, Concha M, Cantero J, Ruffing K, Van Passel L, Hernandez D, Wilson J, Olson-Mack L, Tafreshi G, Zweifler R, Evans P, Lo B, Walker RS, Bright S, Cummings S, Hollsten P, Roldan A, Abdelhak T, Atwood N, Elble R, Kale S, Mueed S, Sabodash V, Singh A, Wang Z, Fritz S, Kelley D, Hussain S, Bansal V, Jani V, Kassab M, Rao M, Razak A, Sachdeva G, Safdar A, Shell E, Murray M, Casper C, Coplin B, Graves A, Smith R, Giambartolomei S, Ellington K, Pulido A, Waldron J, Aubrechtova H, Bogitch R, Carroll E, Horn A, Morledge D, Avila-Michel E, Kappeler K, Morton K, Stephen S, Bath K, Ciabarra A, Moon J, Mossa S, Cruz-Flores S, Acharya A, Alshekhlee A, Callison C, Chaisam T, Edgell R, Feen E, Vora N, Brown S, Holzemer E, Kelly A, Benesch C, Busza A, Chandler J, Dighe G, Holmquist T, Manchak M, Noto A, Richard J, Risco J, Sahin B, Scharf E, Unia R, Finley H, Martin D, Bowling S, Bhalla MC, Gomes J, Jacobson K, Stiffler K, Wilber S, Cunningham K, Mercer L, Roth R, Scharsu R, Wood P, Latorre JG, Ahmad A, Anwer S, Bragin I, Elwaleed E, El-Zammar Z, Fermin AM, Karim S, Mendoza M, Pervez M, Ramdani W, Sangha R, Schmidt E, Hartwell A, Iqbal M, Movileanu I, Brown W, Mahmood MA, Atkinson R, Welcher B, Carter T, Guillen M, Chang I, Bartt R, Burrell C, Fanale C, Fine A, Lampe E, McCarthy K, Nieberlein A, Pratt R, Shine S, Spencer BR, Vanvliet R, Wagner J, Walsh A, Whaley M, Fisk P, Irani T, Neeper L, Novak A, Swanson J, Shah S, Absalom N, Sacks K, Long S, Morgan M, Weinberger J, Chan YF, Horowitz D, Kim F, Lubin A, Sheinart K, Tuhrim S, Wang Q, Augustine S, Franz D, Salem R, Valenta D, Koenig M, Nakagawa K, Dittrich D, Oshita L, Robertson T, Stern T, Silliman S, Antonios N, Crooks R, de Lima M, Fares MA, Farooqui I, Katsafanas C, Khousakoun S, Laboy S, Makar S, Mannel R, Milfred F, Moore O, Ossi R, Plante WJ, Sakho F, Zia A, Bulacan J, Calhoun R, Roberts J, Stegmaier M, Khanna A, Asaithambi G, Berthy J, Dababneh H, Dellorso S, Guerrero W, MacDonald P, Maskas K, Morgan W, Nagaraja N, Naziripour A, Renati S, Rosado C, Shushrutha Hedna V, Smith M, Velez A, Waters M, Weaver M, Wilson C, Youn T, Kizza R, Lyles T, McCombs S, Merritt S, Parfitt D, Warren S, Moonis M, Jun-O'Connell A, Adams M, Glidden B, Alexandrov A, Gropen T, Kumar G, Albright K, Chaudhary A, Lyerly M, Samal A, Sands K, Tkatch D, Cline B, Gazi M, Merritt L, Sisson A, Simpson J, Case D, Coutts D, Graves A, Jones W, Korb P, Leppert M, Neumann R, Pastula D, Poisson S, Vela Duarte D, West M, Bryant A, Hudak M, Lindsay K, Stein A, Torok I, Khaja A, Shafi N, Testai F, Grysiewicz R, Pedelty L, Hillmann M, Adams H, Al Jerdi S, Al Kasab S, Dandapat S, Davis P, Froehler M, Jaksich E, Leira E, Limaye K, Miller J, Ortega-Guiterrez S, Pieper C, Samaniego E, Sheharyar A, Voss A, Olalde H, Sieren J, Liu W, Vaishnav A, Abou-Chebl A, Remmel K, Shah J, Truong V, Wilder M, Jerde A, Abate A, Beckwith A, de Marchena O, Huang D, Mehrabyan A, Morantes L, Smith M, Wang M, Wilson S, Marino S, Poole R, Plinke W, Svenson J, Wheeler N, Ahmed A, Aufderheide T, Bradbury EL, Chacon M, Elliott J, Hamedani A, Jensen M, Mylavarapu K, Sattin J, Tarula E, Doran T, Harris A, Wilbrand S, Gebreyohannas M, Solenski N, Acosta L, Addington J, 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Abstract

BACKGROUND:

Combination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population.

METHODS:

In a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone. The dose of aspirin in each group was selected by the site investigator. The primary efficacy outcome in a time-to-event analysis was the risk of a composite of major ischemic events, which was defined as ischemic stroke, myocardial infarction, or death from an ischemic vascular event, at 90 days.

RESULTS:

A total of 4881 patients were enrolled at 269 international sites. The trial was halted after 84% of the anticipated number of patients had been enrolled because the data and safety monitoring board had determined that the combination of clopidogrel and aspirin was associated with both a lower risk of major ischemic events and a higher risk of major hemorrhage than aspirin alone at 90 days. Major ischemic events occurred in 121 of 2432 patients (5.0%) receiving clopidogrel plus aspirin and in 160 of 2449 patients (6.5%) receiving aspirin plus placebo (hazard ratio, 0.75; 95% confidence interval [CI], 0.59 to 0.95; P=0.02), with most events occurring during the first week after the initial event. Major hemorrhage occurred in 23 patients (0.9%) receiving clopidogrel plus aspirin and in 10 patients (0.4%) receiving aspirin plus placebo (hazard ratio, 2.32; 95% CI, 1.10 to 4.87; P=0.02).

CONCLUSIONS:

In patients with minor ischemic stroke or high-risk TIA, those who received a combination of clopidogrel and aspirin had a lower risk of major ischemic events but a higher risk of major hemorrhage at 90 days than those who received aspirin alone. (Funded by the National Institute of Neurological Disorders and Stroke; POINT ClinicalTrials.gov number, NCT00991029 .).

PMID:
29766750
DOI:
10.1056/NEJMoa1800410
[Indexed for MEDLINE]

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