Dual Antiplatelet Therapy Prevents Neurological Deterioration in Stroke Patients: JAMA Study

A recent study published in the Journal of American Medical Association revealed compelling evidence supporting the efficacy of dual antiplatelet therapy over single antiplatelet treatment for patients suffering from mild to moderate ischemic strokes. 

The study was conducted across 66 hospitals in China from December 20, 2016 to August 9, 2022 and involved a total of 3000 patients with acute mild to moderate strokes that occur within 48 hours of symptom onset. This trial assess the comparative effectiveness of clopidogrel plus aspirin versus aspirin alone in preventing recurrent strokes and minimizing neurological deterioration.

The results unveiled a clear advantage for dual antiplatelet therapy, with patients receiving clopidogrel plus aspirin demonstrating significantly lower rates of early neurological deterioration at 7 days when compared to those treated with aspirin alone. Among the 2915 participants included in the analysis, only 4.8% of those on dual therapy experienced early neurological deterioration when compared to 6.7% in the aspirin-only group.

This study found no significant difference in bleeding events between the two treatment groups that ensures a comparable safety profile for both therapeutic approaches. These findings provide substantial evidence supporting the adoption of dual antiplatelet therapy as a superior option for managing acute ischemic strokes that are mild to moderate in severity.

This study marks a significant stride in stroke care by emphasizing the potential impact of the findings on clinical practice. Overall, these results underline the importance of dual antiplatelet therapy to prevent neurological deterioration and to improve outcomes for individuals with mild to moderate stroke. 

Reference:

Chen, H.-S., Cui, Y., Wang, X.-H., Ma, Y.-T., Han, J., Duan, Y.-J., Lu, J., Shen, L.-Y., Liang, Y., Wang, W.-Z., Wang, H., Zhao, Y., Zhang, J.-T., Song, Y.-L., He, X.-M., Li, R.-H., Tao, D.-B., Li, J., … Huang, S.-M. (2024). Clopidogrel Plus Aspirin vs Aspirin Alone in Patients With Acute Mild to Moderate Stroke. In JAMA Neurology. American Medical Association (AMA). https://doi.org/10.1001/jamaneurol.2024.0146