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Does aspirin plus clopidogrel reduce mortality or morbidity in patients who have had a CVA compared to clopidogrel alone?

TRIP Answers, 2012

Does aspirin plus clopidogrel reduce mortality or morbidity in patients who have had a CVA compared to clopidogrel alone?
Does aspirin plus clopidogrel reduce mortality or morbidity in patients who have had a CVA compared to clopidogrel alone?
The SIGN guideline on the management of patients with stroke or TIA (2) contains a chapter on secondary prevention
In the MATCH trial there was no significant benefit of aspirin and clopidogrel in combination over clopidogrel alone in a high risk population with recent ischaemic stroke or TIA for the combined end point of ischaemic stroke, myocardial infarction, vascular death, or rehospitalisation for acute ischaemia (RRR=6.4%; 95% CI -4.6 to 16.3; p=0.24).
The rate of life threatening and major bleeding was increased in the combination group.204 In the CHARISMA trial a population of patients with multiple
vascular risk factors or established vascular disease was randomised to aspirin in combination with clopidogrel or aspirin alone.
There was no significant difference in the combined end point of MI, stroke or vascular death (RRR=0.93; 95% CI 0.83 to 1.05; p=0.22).
The combination of aspirin and clopidogrel is no more effective than aspirin or clopidogrel alone for secondary prevention of ischaemic stroke but is associated with an increase in moderate or life threatening bleeding.”
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"Does aspirin plus clopidogrel reduce mortality or morbidity in patients who have had a CVA compared to clopidogrel alone?"