The Medical Letter on Drugs and Therapeutics
Secondary Prevention of Stroke
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Revised 2/23/15: In the Clopidogrel Plus Aspirin section, the last sentence has been revised. In the Conclusion, "90 days" has been changed to "21 days".

Recent guidelines from the American Heart Association and American Stroke Association reviewed antithrombotic therapy options for secondary prevention of stroke in patients who have had a stroke or transient ischemic attack (TIA).1

ASPIRIN — Aspirin monotherapy has been shown to reduce the risk of secondary stroke by about 15%. In doses ≤325 mg/day, the annual risk of serious gastrointestinal hemorrhage is about 0.4%, which is 2.5 times the risk without aspirin.2

DIPYRIDAMOLE PLUS ASPIRIN — The antiplatelet drug dipyridamole (Persantine, and generics) is available in combination with aspirin (Aggrenox, and generics). A randomized, controlled trial (ESPRIT) in 2739 patients who had a TIA or minor stroke in the previous 6 months found that a combination of extended-release dipyridamole (200 mg bid) ... more      

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Title: Secondary Prevention of Stroke
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