Clopidogrel with aspirin does not prevent more small strokes

The anti-blood clot regimen that adds the drug clopidogrel (French drug major Sanofi’s blockbuster blood thinner Plavix) to aspirin treatment is unlikely to prevent recurrent strokes and may increase the risk of bleeding and death in patients with subcortical stroke, according to late-breaking research presented at the American Stroke Association’s International Stroke Conference 2012.

Because of these preliminary results, researchers ended the anti-clotting part of the Secondary Prevention of Small Subcortical Strokes Trial (SPS3) in August 2011. The part of the study that examines the effect of high blood pressure treatments will continue. The SPS3 trial is the first large-scale study of patients with subcortical strokes, which occur when small blood vessels deep in the middle of the brain are blocked, damaging small areas of brain tissue. This type of stroke affects about 150,000 Americans each year, and is the most common cause of vascular dementia according to Oscar Benavente, lead author of the study and a professor of neurology at Canada’s University of British Columbia in Vancouver, British Columbia.

American Heart Association/American Stroke Association guidelines for preventing recurrent strokes recommend anti-clotting medications like aspirin, the customary treatment, or other clot preventives like clopidogrel, but not the combination of aspirin plus clopidogrel. Treatments have not been compared in patients with subcortical strokes specifically. In the USA, stroke is the number four killer and a leading cause of disability among adults.