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Randomised controlled trial
Aspirin plus clopidogrel in acute minor ischaemic stroke or transient ischaemic attack is superior to aspirin alone for stroke risk reduction: CHANCE trial
  1. Philip B Gorelick,
  2. Muhammad U Farooq
  1. Mercy Health Hauenstein Neuroscience Center, Grand Rapids, Michigan, USA
  1. Correspondence to: Dr Philip B Gorelick, Mercy Health Hauenstein Neuroscience Center, Vascular Neurology and Stroke, 220 Cherry Street SE, Grand Rapids, MI 49503, USA; pgorelic{at}mercyhealth.com

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Context

Combination therapy with aspirin added to clopidogrel has had a disappointing record in the prevention of recurrent stroke. The management of atherothrombosis with clopidogrel in high-risk patients (MATCH)1 and the secondary prevention of small subcortical strokes (SPS3)2 randomised controlled trials (RCTs) showed that combination therapy was not more effective than clopidogrel or aspirin alone, but was associated with two to three times the risk of major or life-threatening haemorrhage in one study, and major haemorrhages were increased by almost double in the other study. Fast assessment of stroke and transient ischemic attack (TIA) to prevent early recurrence (FASTER), a pilot RCT3 to …

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