Therapeutics
Aspirin plus dipyridamole was more effective than aspirin alone for preventing vascular events after minor cerebral ischaemia
Halkes PH, van Gijn J, Kappelle LJ, et al. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 2006;367:1665–73.[CrossRef][Medline]
Q In patients with recent minor cerebral ischaemia of arterial origin, is aspirin plus dipyridamole (ASA+DP) more effective than aspirin (ASA) alone for preventing vascular events?
IM/Ambulatory medicine Neurology Cardiology
Key Words: anti-inflammatory agents (non-steroidal) • aspirin • cerebrovascular accident • dipyridamole • platelet aggregation inhibitors
| The first 150 words of the full text of this article appear below. |
Design:
randomised controlled trial (European/Australasian Stroke Prevention in Reversible Ischaemia Trial [ESPRIT]).
Allocation:
concealed.*
Blinding:
blinded (outcome auditing committee).*
Follow up period:
mean 3.5 years.
Setting:
79 hospitals in 11 European countries, Singapore, Australia, and the US.
Patients:
2763 patients (mean age 63 y, 65% men) who had had a minor ischaemic stroke (
3 on the modified Rankin scale) (66% of patients), transient ischaemic attack (TIA) (28%), or transient monocular blindness (5%) of presumed arterial origin in the previous 6 months. Exclusion criteria included a possible cardiac source of embolism, high grade carotid stenosis, blood coagulation disorder, and limited life expectancy.
Intervention:
ASA, 30–325 mg (median 75 mg) daily, plus DP, 200 mg twice daily (83% received the extended release formulation) (n = 1375), or ASA alone (n = 1388).
Outcomes:
composite end point of death from all vascular causes, stroke, myocardial infarction, or major bleeding event. Secondary outcomes
Harborview Medical Center, Seattle, Washington, USA
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