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Aspirin Plus Blood Thinners Optimal for Preventing Second Stroke

CardioSmart News

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.

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