Navigation Links
Adding Plavix to Aspirin Doesn't Help Guard Against Second Stroke: Study
Date:8/29/2012

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Aug. 29 (HealthDay News) -- Adding the clot-busting drug Plavix to a daily dose of aspirin is no better than taking aspirin alone to prevent a second stroke in people who have had a type of stroke that is typically caused by chronic high blood pressure, a new study shows.

In fact, the combination increased the risk of gastrointestinal bleeding and death, the Canadian researchers report.

"Antiplatelet therapy is standard for the prevention of a second stroke," said study author Dr. Robert Hart, a professor of neurology at McMaster University in Hamilton, Ontario. "We wanted to see if combining two antiplatelet drugs, aspirin with clopidogrel [Plavix], would work better and prevent more strokes."

"We were disappointed that the combination of aspirin plus clopidogrel only showed a non-significant trend in reducing stroke," Hart said. "On the other side, the two together caused more bleeding and higher mortality. The higher mortality was completely unexpected."

"It is clear that the two drugs together should not be routinely used in people with lacunar stroke," he added.

Lacunar strokes occur in the small blood vessels in the brain and are most likely due to chronic high blood pressure; they account for roughly one-fifth of all strokes and are more common in blacks, Hispanics and people with diabetes.

Although lacunar strokes tend to be small, they can cause disability depending on where in the brain they occur.

The report was published in the Aug. 30 issue of the New England Journal of Medicine.

In the trial, researchers randomly assigned more than 3,000 patients who had suffered a lacunar stroke to a combination of aspirin and Plavix or aspirin and a placebo.

Patients were also randomly selected to receive aggressive blood pressure control or standard blood pressure control, the researchers noted.

Over eight years of follow-up, the rate of second strokes among those on the two drugs was 2.5 percent, compared with 2.7 percent among those taking just aspirin, they found.

Most of these second strokes were lacunar strokes, they noted. Overall, the number of second strokes in both groups was cut threefold, which was a bigger reduction than expected.

However, the rate of serious bleeding was 2.1 percent in the aspirin/Plavix group and 1.1 percent in the aspirin-only group, the researchers noted.

Moreover, there were more deaths among those taking both drugs, with 77 deaths in the aspirin group and 113 deaths in the aspirin/Plavix group, the researchers found. The reasons for the increased death rate isn't known, but is being investigated, Hart said.

In August 2011, the trial was stopped because of the results. The U.S. National Institutes of Health (NIH), which funded the study, warned at the time that there was "little likelihood of benefit in favor of aspirin plus clopidogrel [Plavix] [for] recurrent stroke should the study continue to conclusion."

The blood pressure treatment part of the trial is ongoing, and the patients have been encouraged to continue taking aspirin without Plavix, according to the NIH.

Current guidelines recommend aspirin alone, Plavix alone, or aspirin plus dipyridamole (Permole) for preventing new strokes after most types of stroke, Hart noted.

Whether a combination of Plavix and aspirin is effective in preventing other types of stroke isn't known, but is being studied, he added.

"I am a little surprised, but not shocked by this finding," said Dr. Kirk Garratt, director of interventional cardiovascular research at Lenox Hill Hospital, in New York City. "It's another disappointing finding for antiplatelet drugs. The lesson here is we shouldn't start writing prescriptions for Plavix to those patients with lacunar strokes. Practitioners have to pay attention to these negative trials."

More information

For more on stroke, visit the American Stroke Association.

SOURCES:Robert Hart, M.D., professor, neurology, McMaster University, Hamilton, Ontario, Canada; Kirk Garratt, M.D., director, interventional cardiovascular research, Lenox Hill Hospital, New York City; Aug. 30, 2012, New England Journal of Medicine


'/>"/>
Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Adding drug to standard chemotherapy provides no survival benefit for older lung cancer patients
2. Adding Vitamin B12 to Standard Drugs Might Help Fight Hepatitis C
3. Adding More Neurosurgeons Could Cut Traffic Deaths: Study
4. Plavixs New Generic Status Could Be Boon for Patients
5. FDA Approves Generic Versions of Plavix
6. New Blood Thinner Effient No Better Than Plavix at Preventing Heart Trouble: Study
7. Report says new evidence could tip the balance in aspirin cancer prevention care
8. Aspirin as Effective as Warfarin for Heart Failure: Study
9. Some Diabetics May Not Benefit From Daily Aspirin
10. Aspirin protects against Barretts esophagus
11. Study adds to evidence daily aspirin linked to lower cancer mortality
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Adding Plavix to Aspirin Doesn't Help Guard Against Second Stroke: Study
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the ... In terms of the latter, setting the bar too high can result in disappointment, ... just slow progress toward their goal. , Research from PsychTests.com reveals ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events ... turn to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. ... tools for healthy coping following a traumatic event. , Trauma sufferers tend to feel ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was out ... family verbally and physically. , “When something upset him, he couldn’t control his emotions,” remembers ... would throw rocks at my other children and say he was going to kill them. ...
(Date:6/24/2016)... ... ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys are ... for this recognition are considered among the top 2 percent of lawyers practicing within ... of this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. Bloom, ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Comfort Keepers® of ... Cancer Society and the Road To Recovery® program to drive cancer patients to and ... other adults to ensure the highest quality of life and ongoing independence. Getting ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... ALEXANDRIA, Va. , June 24, 2016 ... a set of recommendations that would allow ... information (HCEI) with entities that make formulary and coverage ... determine the "value" of new medicines. The ... that does not appear on the drug label, a ...
(Date:6/24/2016)... India , June 24, 2016 ... Needles Market by Type (Standard Pen Needles, Safety Pen ... Therapy (Insulin, GLP-1, Growth Hormone), Mode of Purchase (Retail, ... by MarketsandMarkets, This report studies the market for the ... expected to reach USD 2.81 Billion by 2021 from ...
(Date:6/23/2016)... 2016  MedSource announced today that it has ... solution of choice.  This latest decision demonstrates MedSource,s ... their clients by offering a state-of-the-art electronic data ... nowEDC as the EDC platform of choice in ... "nowEDC has long been a preferred EDC platform ...
Breaking Medicine Technology: