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New-onset migraine attacks are reported by about 15% of patients after transcatheter atrial septal defect (ASD) closure. Since migraine attacks are linked to a number of mechanisms (e.g., platelet dysfunction, coagulation disorders, activation of vasoactive substances and inflammatory cytokines), therapeutic approaches have differed. Observational studies have shown a reduction in migraine attacks with dual antiplatelet therapy. Now, Canadian investigators have conducted a randomized trial to assess the effects of clopidogrel plus aspirin after ASD closure. (The study was cofunded by the manufacturers of clopidogrel and the closure device.)
A total of 171 patients (mean age, 49; 62% women) received aspirin (80 mg/day) plus either placebo or …