Combination Antiplatelet Therapy for Transient Ischemic Attack or Minor Stroke: Does It Work?

To compare the effects of aspirin plus clopidogrel with aspirin alone in minor stroke or transient ischemic attack (TIA), more than 100 centers in China recruited a total of 5170 patients with a diagnosis of “high-risk” TIA or minor stroke within 24 hours of symptom onset. High-risk TIA was defined as a score of ≥4 on the ABCD² scale, which is based on age, blood pressure, and other clinical variables. Minor stroke was defined as a score of ≤3 on the NIH Stroke Scale score.

All patients received aspirin (75–300 mg) on day 1 and 75 mg of aspirin through day 21. Those randomized to dual antiplatelet therapy received 300 mg of clopidogrel on day 1 and 75 mg on days 2 through 90, with aspirin placebo on days 22 through 90. Those randomized to as…