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Systematic review and meta-analysis
Dual antiplatelet therapy in recurrent stroke prevention: do the benefits outweigh the risks?
  1. Muhammad U Farooq1,
  2. Philip B Gorelick2
  1. 1Section of Vascular Neurology and Stroke, Hauenstein Neuroscience Center, Grand Rapids, Michigan, USA;
  2. 2Michigan State University, Grand Rapids, Michigan, USA
  1. Correspondence to: Dr Muhammad U Farooq, Section of Vascular Neurology and Stroke, Hauenstein Neuroscience Center, 220 Cherry Street SE, Grand Rapids, Michigan 49503, USA; farooqmu{at}mercyhealth.com

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Context

Dual antiplatelet therapy (DAT) has yet to prove advantageous when taking into account the net risks and benefits of longer term administration. The primary drawback is the risk of bleeding complications, including intracranial haemorrhage and gastrointestinal bleeding.1 ,2 However, shorter term combination therapy after transient ischaemic attack (TIA) has been shown to be efficacious and safe.3 ,4

Methods

This study assessed seven randomised controlled trials, comprising 39 574 patients and comparing dual versus single antiplatelet therapies. Medications used included aspirin (50–325 mg daily), clopidogrel (75 mg daily), aspirin plus dipyridamole (50/400 mg daily) …

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