Journal of Developing Drugs
Open Access

Abstract

Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemia Attack: A Scoping Review

Peter Jo*

The early risk of recurrence of stroke following index transient ischemic attack (TIA) or minor ischemic stroke is very high, even in patients treated with aspirin. The Clopidogrel in High risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial was designed to assess whether the combination treatment of clopidogrel and aspirin taken soon after a TIA or minor stroke could reduce the early risk of stroke. The original study termination of the CHANCE trial was 90 days from randomization, and the results showed that clopidogrel aspirin treatment decreases the 90 day risk of stroke hazard ratio, 0.68, 95% confidence interval (CI), 0.57–0.81; P<0.001) but does not increase the risk of haemorrhage in comparison with aspirin alone. The secondary prevention strategy with one single antiplatelet drug of clopidogrel or aspirin does reduce, but abolish, further events such as recurrent ischemic stroke. This “resistance phenomenon” suggests that blocking target is far from cutting off the whole thrombotic process. Dual antiplatelet drugs working on various thrombotic targets show higher antithrombotic efficacy. The combination therapy with clopidogrel and aspirin main drug used worldwide and provides definite clinical benefit, which has been the standard practice for acute coronary syndrome

Published Date: 2022-12-15; Received Date: 2022-12-15