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Therapeutics
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

https://doi.org/10.1136/eb-2013-101642

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    Commentary on: Lee M, Saver JL, Hong KS, et al. Risk-benefit profile of long-term dual-versus single-antiplatelet therapy among patients with ischemic stroke: a systematic review and meta-analysis. Ann Intern Med 2013;159:463–70.OpenUrlCrossRefPubMedWeb of Science

    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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    Footnotes

    • Competing interests None.