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Recent studies have emphasized that a high risk for neurologic deterioration immediately follows ischemic events that either are transient or leave mild persistent deficits. However, an effective intervention strategy has yet to be demonstrated.
These investigators prospectively tested the efficacy of clopidogrel and simvastatin (individually or in combination) in reducing stroke risk when initiated within 24 hours of the initial symptoms. All patients received low-dose aspirin (81 mg daily) and were then randomized in factorial design to additionally receive clopidogrel (a 300 mg loading dose followed by 75 mg daily), simvastatin (40 mg daily), or both. The mean time to randomization was 8 to 9 hours. Follow-up data were available for analy…