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Aug 11, 2017

Aspirin Plus Blood Thinners are Optimal for Preventing Second Stroke

An analysis of five studies shows aspirin alone is not ideal for preventing a second stroke in many patients.

Aspirin alone is not ideal for preventing a second stroke, based on a recent analysis that linked aspirin plus blood thinners to better outcomes in stroke survivors.

Published in the American Heart Association journal Stroke, this study assessed the benefits of daily aspirin after stroke. It analyzed data from five studies, which together included more than 8,700 patients with a history of ischemic stroke or transient ischemic attack.

Ischemic stroke is the most common type of stroke. It occurs when a blood clot obstructs blood flow to the brain. Transient ischemic attack, often referred to as a mini stroke, is similar but typically lasts a few minutes and causes no permanent damage. Blood thinners like aspirin are critical to reducing risk for a second stroke, as they help prevent blood clots that could cause future events. However, it’s unknown exactly what the optimal combination of aspirin and blood thinners are in ischemic and mini stroke survivors.

To learn more, researchers compared therapies and outcomes among 8,723 stroke survivors who were followed for up to three and a half years. Some patients took aspirin alone, while others took aspirin plus a prescription blood thinner (clopidogrel or ticagrelor).

After analysis, researchers found that participants adding or switching to another blood thinner, in addition to daily aspirin, had 30% lower risk for stroke and 32% lower risk for heart events. They also found that starting treatment in the first days after patients’ initial stroke was most effective in preventing future heart events.

The take-home message, according to authors, is that aspirin plus prescription blood thinners may be most effective at preventing a second stroke. Findings also highlight the importance of starting treatment immediately after a first stroke to help prevent future events.

However, it’s important to note that findings only apply to survivors of ischemic stroke or transient ischemic attack. Using blood thinners in survivors of a hemorrhagic stroke, which occurs when there’s bleeding in the brain, could be very harmful and increase risk for future events.

Questions for You to Consider

  • How does aspirin help prevent heart attack and stroke?

  • Aspirin helps prevent heart attack and stroke by reducing blood clotting. Although blood clotting is the body’s natural way of healing damaged blood vessels, blood clots can travel to the heart and block major arteries, causing heart attack or stroke. Therefore, those at high risk for heart attack and stroke often take aspirin to help reduce clotting and risk for future cardiac events.
  • What is a blood thinner?
  • A blood thinner slows down the blood's ability to form clots. This helps prevent clots that can cause life-threatening problems such as stroke, heart attack and pulmonary embolism. These medicines also can keep blood clots from getting bigger. Blood thinner medicines work in different ways to prevent blood clots, but all of them raise the risk of serious bleeding.

Featured Video

A stroke occurs when a blood vessel in the brain is blocked or bursts. Watch this video to learn about what symptoms to watch for.

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Infographic: Stroke

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