NIHR Signal: Adding a third antiplatelet drug after a stroke increases harms but not benefits

National Institute for Health Research Signal

Expert commentary notes even with rapid implementation of secondary prevention, risk of recurrent ischaemic stroke is high with greatest risk in first 30 days, hence temptation to add antiplatelet agents, though this results in no additional benefit and increases bleeding.

Dual Antiplatelet Therapy in Transient Ischemic Attack and Minor Stroke With Different Infarction Patterns: Subgroup Analysis of CHANCE Randomized Clinical Trial

JAMA Neurology

Imaging substudy of CHANCE (n=1089) found infarction (IF) patterns can efficiently stratify risk of recurrent stroke within 3 months of non-cardioembolic TIA/minor ischaemic stroke. Patients with multiple acute IFs received most pronounced clinical benefit from dual antiplatelets.

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:

http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services