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Intensive antiplatelet therapy reduces risk for recurrent events in TIA

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Patients with transient ischemic attack who were treated with intensive antiplatelet therapy had a reduced risk for a recurrent TIA compared with those treated with guideline antiplatelet therapy, according to an abstract presented at the International Stroke Conference.

Philip M. Bath, DSc, FAHA , Stroke Association Professor of Stroke Medicine and head of the division of clinical neuroscience at the University of Nottingham in England, and colleagues analyzed data from 953 patients (mean age, 70 years; 62% men) from the TARDIS trial who had a TIA. Patients were assigned to intensive antiplatelet therapy (n = 480), which was a combination of aspirin, clopidogrel and dipyridamole, or guideline antiplatelet therapy (n = 473), which was clopidogrel alone or combined with dipyridamole and aspirin.

The primary outcome was recurrent cerebral events and their severity as assessed by the modified Rankin Scale at 3 months.

Throughout the first 90 days, both treatment groups did not have any differences in the rates of death, stroke and TIA, or other functional outcomes. Patients assigned intensive antiplatelet therapy had less recurrent TIA compared with those assigned guideline antiplatelet treatment (OR = 0.48; 95% CI, 0.25-0.93).

“The risk of recurrence following an ischemic stroke or transient ischemic attack is high, especially immediately after the event,” Bath and colleagues wrote in the abstract. “Overall, the trial was neutral, although intensive treatment led to more bleeding, so there is no advantage of triple antiplatelet therapy, and current guidelines should be followed.” – by Darlene Dobkowski

Reference:

Woodhouse LJ, et al. Abstract 103. Presented at: International Stroke Conference; Jan. 23-26, 2018; Los Angeles.

Disclosures: Bath reports he has ownership interest in DiaMedica Therapeutics and Platelet Solutions and is a consultant/advisory board for Nestle, Phagenesis and ReNeuron.