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Aspirin is widely used for secondary stroke prevention, but gastrointestinal bleeding can limit its use. Other antiplatelet agents with similar mechanisms of action might have comparable efficacy. Indobufen, like aspirin, inhibits the platelet cyclooxygenase enzyme, which reduces thromboxane synthesis, so it could be useful for stroke prevention. High-quality comparative data against aspirin are lacking. These authors conducted an industry-funded, randomized trial (INSURE) in China for patients with moderate-to-severe stroke comparing indobufen (100 mg twice daily) versus aspirin 100 mg daily. Eligible patients had an NIH stroke scale score of 4 to 18, did not have cardioembolic stroke, and could be treated within 72 hours after stroke onse…