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Mar 06, 2013

Duo of Anticoagulants Could Help Patients after 'Mini' Stroke

A Chinese study finds that combining aspirin with clopidrogel (Plavix) after a transient ischemic attack (TIA) helped reduce the risk of having a subsequent stroke.

Transient ischemic attack (TIA) is a type of “mini” stroke where blood flow to the brain stops for a short period of time, but doesn’t cause brain tissue to die. Although a TIA may not be life threatening on its own, it’s considered a warning sign that a true stroke may happen in the near future. In fact, many people will have a “real” stroke within 30 days of their TIA. Fortunately, we know what the major risk factors are for TIAs and strokes, such as high blood pressure, so we can help patients reduce their stroke risk with a combination of medication and lifestyle changes. And according to a study conducted at several Chinese medical centers, taking a duo of anticoagulants may help drastically reduce risk of stroke following a TIA.

This study tested whether aspirin or a combination of aspirin and another anti-clotting medication, clopidrogel (Plavix), was more effective in preventing strokes in TIA patients. Currently, prescribing aspirin to a patient following a TIA is standard practice, as aspirin interferes with the body’s ability to form blood clots, reducing stroke risk. But experts were curious if prescribing additional anticoagulant medication might help further reduce risk of stroke following a TIA.

After prescribing aspirin or aspirin plus clopidrogel to more than 5,100 patients who had either a minor stroke or TIA, researchers found that the combination of aspirin and clopidrogel helped reduce risk of having a stroke within 90 days by 32%, compared to those receiving aspirin alone. Also, although anti-clotting medications can increase risk of bleeding in patients, patients taking aspirin plus clopidrogel still had a similar risk of bleeding compared to those taking aspirin alone, although risk was slightly higher (2.3% vs. 1.6% bleeding risk).

Experts are encouraged by results, but also cautious about relying on these findings too heavily. Since the study was conducted in China, results may not be as applicable to the U.S. population. However, a similar study called the POINT trial is currently being conducted in the U.S.—the results of which could confirm whether findings from the Chinese study are valid. And doctors say that if the POINT trial confirms findings, the combined treatment of aspirin with clopidrogel could become the new “gold standard” for treating patients with TIA.

Questions for You to Consider

  • If I have had a transient ischemic attack (TIA), should I be concerned about having a stroke?
  • Yes. TIAs are considered a warning sign that a true stroke may happen in the near future, especially if risk factors aren’t addressed and reduced. Many people who have had a TIA will have a stroke within 30 days of their TIA, so seeking treatment to reduce risk factors is important to reducing risk of having a stroke.
  • What are symptoms of a transient ischemic attack (TIA)?
  • The symptoms of TIA are the same as symptoms of stroke, including sudden dizziness, drooping in the face, numbness or tingling on one side of the body, lack of balance, and loss of vision in one or both eyes. Symptoms of a TIA begin suddenly, only last a short time (a few minutes to 1-2 hours) and go away completely after. It’s important to call 911 at first sign of any of these symptoms.

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