Adding the anti-clotting drug Plavix to daily doses of aspirin helps prevent the risk of later strokes better than using aspirin alone, British researchers reported Monday.
Plavix, sold by Sanofi-Aventis and Bristol-Myers Squibb Co. had in earlier trials proven able to help prevent second heart attacks, strokes and death among patients who had suffered heart attacks.
Now a study shows the Plavix/aspirin combination can also reduce the number of tiny blood clots that can predict the risk of stroke, including so-called mini-strokes, in stroke patients.
“The combination of clopidogrel and aspirin was significantly more effective at reducing blood clots than if we used aspirin alone,” said Dr. Hugh Markus of St. George’s Hospital Medical School in London, who led the study.
Writing in the journal Circulation, published by the American Heart Association, Markus and colleagues said they studied 107 stroke patients at 11 medical centers in France, Germany, Switzerland and Britain.
All had at least 50 percent narrowing of the carotid artery, which is the main vessel carrying blood to the brain. Each had suffered a stroke or a transient ischemic attack -- a mini-stroke -- within the last three months.
For the study, called Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic Carotid Stenosis or CARESS, about half the patients got aspirin plus Plavix, generically known as clopidogrel, and half got aspirin alone for a week.
The team used transcranial Doppler ultrasound to look for little blood clots called microemboli in the brain.
Microemboli were detected in 43.8 percent of the patients who got both drugs compared to 72.7 percent of the group treated with aspirin only.
Stroke patients risk another stroke, especially within the first week, studies show. “The risk is particularly high in patients with narrowed carotid arteries, which suggests that more aggressive anti-clotting therapy may be indicated in this patient group,” Markus said in a statement.
“The results demonstrate the power of the technique to detect treatment effects in relatively small groups of patients, far less than those required with the use of clinical end points such as stroke, and suggest this technique may help screen different drug combinations for further testing in large and expensive clinical trials,” Markus said.
