16 May Benefits of Clopidogrel and Aspirin In Minor Stroke and High-Risk TIA
MedicalResearch.com Interview with:
Dr. Johnston
Dr. S. Claiborne “Clay” Johnston MD, PhD
Dean
Vice President for Medical Affairs
Frank and Charmaine Denius Distinguished Dean’s Chair
Dell Medical School
The University of Texas at Austin
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior studies have shown that the risk of a stroke or other ischemic events is high in the days to weeks after a TIA or minor stroke.
We sought to test whether blocking platelet aggregation more effectively with clopidogrel plus aspirin could reduce this risk compared to aspirin alone. We found that the combination did reduce risk of major ischemic events. It also showed a small increase in risk of major hemorrhage, but for most people the benefits would outweigh the potential risk.
MedicalResearch.com: What should readers take away from your report?
Response: Patients with minor ischemic stroke and high-risk TIA should be seen emergently. One option for treatment is the combination of clopidogrel and aspirin.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Clopidogrel doesn’t work in everyone; more than a quarter of people of European ancestry (and a larger proportion of those with Asian decent) don’t convert clopidogrel to active form. We need better drugs. Ticagrelor is an option and the THALES trial is attempting to study it in a population similar to POINT.
Disclosures: The trial was sponsored by NINDS/NIH. Sanofi provided drug and placebo for 75% of enrollees. My institution has received research support for the THALES trial from AstraZeneca.
Citation:
Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA
Claiborne Johnston, M.D., Ph.D.,Donald Easton, M.D.,Mary Farrant, M.B.A.,William Barsan, M.D.,Robin A. Conwit, M.D.,Jordan J. Elm, Ph.D.,Anthony S. Kim, M.D.,Anne S. Lindblad, Ph.D.,and Yuko Y. Palesch, Ph.D.for the Clinical Research Collaboration, Neurological Emergencies Treatment Trials Network, and the POINT Investigators* May 16, 2018
DOI: 10.1056/NEJMoa1800410
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Last Updated on May 17, 2018 by Marie Benz MD FAAD