Muhammad Faisal Wadiwala, Ayeesha Kamran Kamal.
What is better antiplatelet agent to prevent recurrent stroke?.
J Pak Med Assoc Jan ;62(9):976-7.

Aspirin and Extended-Release Dipyridamole versus Clopidogrel for Recurrent StrokePrevention Regimen for Effectively Avoiding Second Strokes(PRoFESS) Study Group. Why is this study of clinical importance? Stroke is the second leading cause of death in the world. However, nonfatal stroke is approximately 3 times as common as fatal stroke; therefore, secondary prevention to prevent stroke is a critical treatment priority. Clinical trials have proved the efficacy of antiplatelet agents for the prevention of recurrent stroke after non-cardioembolic stroke. Antiplatelet options for the prevention of recurrent stroke includes aspirin (50 mg to 325 mg per day), the combination of low dose aspirin and extended-release dipyridamole, and clopidogrel alone. Aspirin has shown to reduce the stroke recurrence risk by about 23% as compared with placebo. Clopidogrel has shown 8% relative risk reduction of stroke recurrence, as compared with aspirin, among stroke patients. Studies of aspirin plus extended-release dipyridamole have suggested relative risk reductions of 20 to 23% as compared with aspirin alone. Combination of two antiplatelet agents with different mechanisms of action maybe more effective in preventing recurrent stroke than either is alone, increased bleeding may result. There is no guideline for using one of these therapies over the other. Thus, this trial was aimed to compare the relative efficacy and safety of aspirin plus extended-release dipyridamole with that of clopidogrel among patients who had a recent ischaemic stroke.

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