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In the previously published SPS3 trial, 3000 patients who experienced lacunar strokes during the previous 6 months were randomized to receive aspirin alone or aspirin plus clopidogrel. During several years of follow-up, dual antiplatelet therapy did not prevent recurrent stroke and increased risk for major hemorrhage and death (NEJM JW Neurol Aug 29 2012). Now, in a post hoc analysis from this study, researchers present data on the 838 patients who already had been taking prophylactic aspirin at the time of the lacunar stroke that qualified them for the trial.
Outcomes in this subgroup mirrored those of the larger study. During mean follow-up of 3.5 years, the annual stroke rate was 3% in both the aspirin monotherapy and dual antiplatelet th…