In the SPS3 trial, clopidogrel added to aspirin increased bleeding and mortality without providing a compensatory benefit.
Long-term dual antiplatelet therapy has not been rigorously assessed in patients with specific ischemic stroke subtypes other than that associated with atrial fibrillation (JW Neurol Aug 11 2009).
The antiplatelet arm of the multicenter Secondary Prevention of Small Subcortical Strokes (SPS3) trial was designed to compare aspirin with or without clopidogrel specifically in patients with lacunar stroke — a small subcortical infarct caused by intrinsic small-vessel disease.
Patients qualified for SPS3 if they were aged ≥30 and had experienced a recent symptomatic lacunar stroke, defined as a typical clinical syndrome along with a compatible magnetic resonance imaging lesion. At a median of about 2 months after the qualifying stroke, 3020 patien…
Reviewing Author
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)