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MAUI, HAWAII — A large international study showed aspirin plus dipyridamole worked better than aspirin alone in preventing a major vascular event following a transient ischemic attack or a minor stroke of arterial origin, Dr. Gregory W. Albers said at a symposium on emergency medicine sponsored by Stanford School of Medicine.
The recent European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT) was a randomized, open-label study of 2,739 patients who had experienced nondisabling cerebral ischemia of presumed arterial origin, said Dr. Albers, who is professor of neurology and neurological sciences and director of the Stanford Stroke Center, Stanford (Calif.) University Medical Center.
The ESPRIT designers wanted to know whether a combination of aspirin (30–325 mg) plus dipyridamole (200 mg b.i.d.) was better than aspirin (30–325 mg) alone at preventing the primary outcome of stroke, myocardial infarction, major bleeding events, or death from vascular causes (Lancet 2006;367:1665–73). Average patient follow-up was 3.5 years.
There was a statistically significant 20% risk reduction for the combination therapy, he said. “Not only were there fewer strokes, but there were fewer cardiac events,” he said.
“For whatever reason, bleeding doesn't seem to be such an issue, probably because dipyridamole is not much of an antiplatelet agent,” he added. “You don't get the same long-term bleeding effects with dipyridamole and aspirin as you get with clopidogrel and aspirin.”
The Netherlands-based study was a secondary stroke prevention trial not funded by a drug company.
MAUI, HAWAII — A large international study showed aspirin plus dipyridamole worked better than aspirin alone in preventing a major vascular event following a transient ischemic attack or a minor stroke of arterial origin, Dr. Gregory W. Albers said at a symposium on emergency medicine sponsored by Stanford School of Medicine.
The recent European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT) was a randomized, open-label study of 2,739 patients who had experienced nondisabling cerebral ischemia of presumed arterial origin, said Dr. Albers, who is professor of neurology and neurological sciences and director of the Stanford Stroke Center, Stanford (Calif.) University Medical Center.
The ESPRIT designers wanted to know whether a combination of aspirin (30–325 mg) plus dipyridamole (200 mg b.i.d.) was better than aspirin (30–325 mg) alone at preventing the primary outcome of stroke, myocardial infarction, major bleeding events, or death from vascular causes (Lancet 2006;367:1665–73). Average patient follow-up was 3.5 years.
There was a statistically significant 20% risk reduction for the combination therapy, he said. “Not only were there fewer strokes, but there were fewer cardiac events,” he said.
“For whatever reason, bleeding doesn't seem to be such an issue, probably because dipyridamole is not much of an antiplatelet agent,” he added. “You don't get the same long-term bleeding effects with dipyridamole and aspirin as you get with clopidogrel and aspirin.”
The Netherlands-based study was a secondary stroke prevention trial not funded by a drug company.
MAUI, HAWAII — A large international study showed aspirin plus dipyridamole worked better than aspirin alone in preventing a major vascular event following a transient ischemic attack or a minor stroke of arterial origin, Dr. Gregory W. Albers said at a symposium on emergency medicine sponsored by Stanford School of Medicine.
The recent European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT) was a randomized, open-label study of 2,739 patients who had experienced nondisabling cerebral ischemia of presumed arterial origin, said Dr. Albers, who is professor of neurology and neurological sciences and director of the Stanford Stroke Center, Stanford (Calif.) University Medical Center.
The ESPRIT designers wanted to know whether a combination of aspirin (30–325 mg) plus dipyridamole (200 mg b.i.d.) was better than aspirin (30–325 mg) alone at preventing the primary outcome of stroke, myocardial infarction, major bleeding events, or death from vascular causes (Lancet 2006;367:1665–73). Average patient follow-up was 3.5 years.
There was a statistically significant 20% risk reduction for the combination therapy, he said. “Not only were there fewer strokes, but there were fewer cardiac events,” he said.
“For whatever reason, bleeding doesn't seem to be such an issue, probably because dipyridamole is not much of an antiplatelet agent,” he added. “You don't get the same long-term bleeding effects with dipyridamole and aspirin as you get with clopidogrel and aspirin.”
The Netherlands-based study was a secondary stroke prevention trial not funded by a drug company.