title: The efficacy and safety of aspirin plus dipyridamole versus aspirin in secondary prevention following TIA or stroke: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Stroke is becoming a common disease worldwide, and has an increased rate of recurrence yearly after a transient ischemic attack (TIA) or stroke. Aspirin, dipyridamole, clopidogrel and aspirin plus dipyridamole combination therapy have been recommended for the secondary prevention of stroke in Americans.
  
  
  METHODS
  We performed meta-analyses to assess the effectiveness and safety of combination therapy with aspirin and dipyridamole (A+D) versus aspirin (A) alone in secondary prevention after transient ischemic attack (TIA) or stroke of presumed arterial origin within one week and six months.
  
  
  METHODS
  Medline, Embase, and the Cochrane Library.
  
  
  METHODS
  Eligible studies were completed randomized controlled trials investigating the effect of aspirin plus dipyridamole versus aspirin in patients with previous TIA or stroke.
  
  
  RESULTS
  Five trials involving the use of aspirin and dipyridamole were included, 4318 allocated to A+D and 4304 to A alone. Meta-analysis of trials showed a significant protective effect of reducing or preventing recurrence of stroke (P=0.01), and ischemic event (P=0.003). The statistics showed no significant difference in vascular event, death from all cause and myocardial infarction (P>0.05). There were similarities with all bleeding events, major bleeding and intracranial hemorrhage was significant (P>0.05) between two groups.
  
  
  CONCLUSIONS
  Aspirin plus dipyridamole combination therapy was beneficial in reducing the recurrence of stroke, and did not increase the bleeding event. Hence, aspirin plus dipyridamole combination therapy is effective and safe for the secondary prevention of stroke.
authors.affiliation: Department of Intensive Care Units, Gongren Hospital of Liuzhou, Guangxi, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.forename: Guoyu
authors.initials: G
authors.lastname: Zhou
authors.forename: Xueying
authors.initials: X
authors.lastname: Zhou
authors.forename: Shengnian
authors.initials: S
authors.lastname: Zhou
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D004176:Dipyridamole / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy*
chemical_list: D005343:Fibrinolytic Agents; D004176:Dipyridamole; D001241:Aspirin
keywords: Antiplatelet; Aspirin; Combination therapy; Dipyridamole; Meta analysis; Stroke prevention