Clopidogrel plus aspirin prevents early neurologic deterioration and improves 6-month outcome in patients with acute large artery atherosclerosis stroke.

Abstract

To evaluate the effects of treatments with clopidogrel plus aspirin (dual therapy) on early neurological deterioration (END) and outcomes at 6 months in patients with acute large artery atherosclerosis (LAA) stroke. A total of 574 patients with LAA stroke were randomly assigned to receive either dual therapy or aspirin alone (monotherapy). The primary outcome was END. Secondary outcomes included recurrent ischemic stroke (RIS) and outcomes at 6 months. The prevalence of END and RIS was lower in patients on dual therapy than in those on monotherapy during the 30 days. At 6 months, dual therapy improved outcomes among older patients and those with symptomatic stenosis in the posterior circulation and basilar artery. Clopidogrel plus aspirin is superior to aspirin alone for reducing END and RIS within 30 days and improves outcomes in certain subgroups at 6 months.