Triple antiplatelet therapy for secondary prevention of recurrent ischemic stroke.
Antiplatelet agents are effective for secondary prevention after ischemic stroke, although they do not always prevent recurrent events. Laboratory studies confirm that therapy with 3 antiplatelet agents is superior to dual therapy or monotherapy at inhibiting platelet and leucocyte function. We report here a 69-year-old man who had recurrent strokes despite single or dual antiplatelet agents, but who responded to a combination of aspirin, dipyridamole, and clopidogrel. Likewise, triple antiplatelet therapy was effective in a series of 8 additional patients during a period of 28 months of follow up. Because combining 3 agents runs the risk of major bleeding, clinical trials are essential to address issues of safety and efficacy in patients with stroke.
Willmot
Mark
M
University of Nottingham, Institute of Neurosciences, Nottingham, United Kingdom.
Zhao
Lian
L
Heptinstall
Stan
S
Bath
Philip
P