Comparison of administration of clopidogrel with aspirin versus aspirin alone in prevention of secondary stroke after transient ischemic attack

Abstract

Patients with transient ischemic attack (TIA) or minor stroke are at risk of strokes. One of the precautionary measures to reduce risk of stroke in these patients is administration of antiplatelet drugs. The aim of this study was comparison of clopidogrel with aspirin versus aspirin alone in prevention of stroke following TIA or acute minor stroke. This clinical trial study was carried out in Farshchian Hospital, Hamadan, Iran in 2018. Fifty-four patients with TIA, isolated visual attacks, and minor stroke were randomly assigned to receive aspirin 80 mg/day or aspirin 80 mg/day and clopidogrel 75 mg/day for 3 months. After this period, patients were examined for occurrence of myocardial stroke, hemorrhagic/ischemic stroke and drug complications. Ischemic stroke or TIA occurred in 5 (18.5%) patients in clopidogrel–aspirin group and 10 patients (37.1%) in aspirin group (P = 0.12). The study suggests a trend toward superiority of administration of clopidogrel with aspirin versus aspirin alone in protection against secondary stroke. Studies in larger cohorts of patients are needed to verify these results.