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  • Sacco, R. L.Miller School of Medicine, University of Miami, Miami, United States; Miller School of Medicine, University of Miami, Miami, United States,McMaster University, Hamilton, ON, Canada (författare)

Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke

  • Artikel/kapitelEngelska2008

Förlag, utgivningsår, omfång ...

  • Boston :Massachusetts medical society,2008

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/77923
  • https://gup.ub.gu.se/publication/77923URI
  • https://doi.org/10.1056/NEJMoa0805002DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-81162URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:117567180URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared the efficacy and safety of two antiplatelet regimens--aspirin plus extended-release dipyridamole (ASA-ERDP) versus clopidogrel. METHODS: In this double-blind, 2-by-2 factorial trial, we randomly assigned patients to receive 25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or to receive 75 mg of clopidogrel daily. The primary outcome was first recurrence of stroke. The secondary outcome was a composite of stroke, myocardial infarction, or death from vascular causes. Sequential statistical testing of noninferiority (margin of 1.075), followed by superiority testing, was planned. RESULTS: A total of 20,332 patients were followed for a mean of 2.5 years. Recurrent stroke occurred in 916 patients (9.0%) receiving ASA-ERDP and in 898 patients (8.8%) receiving clopidogrel (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11). The secondary outcome occurred in 1333 patients (13.1%) in each group (hazard ratio for ASA-ERDP, 0.99; 95% CI, 0.92 to 1.07). There were more major hemorrhagic events among ASA-ERDP recipients (419 [4.1%]) than among clopidogrel recipients (365 [3.6%]) (hazard ratio, 1.15; 95% CI, 1.00 to 1.32), including intracranial hemorrhage (hazard ratio, 1.42; 95% CI, 1.11 to 1.83). The net risk of recurrent stroke or major hemorrhagic event was similar in the two groups (1194 ASA-ERDP recipients [11.7%], vs. 1156 clopidogrel recipients [11.4%]; hazard ratio, 1.03; 95% CI, 0.95 to 1.11). CONCLUSIONS: The trial did not meet the predefined criteria for noninferiority but showed similar rates of recurrent stroke with ASA-ERDP and with clopidogrel. There is no evidence that either of the two treatments was superior to the other in the prevention of recurrent stroke. (ClinicalTrials.gov number, NCT00153062.)

Ämnesord och genrebeteckningar

  • MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
  • MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors/therapeutic use
  • Aspirin/*administration & dosage/adverse effects
  • Benzimidazoles/therapeutic use
  • Benzoates/therapeutic use
  • Brain Ischemia/epidemiology/prevention & control
  • Delayed-Action Preparations
  • Dipyridamole/adverse effects/*therapeutic use
  • Double-Blind Method
  • Drug Therapy
  • Combination
  • Factor Analysis
  • Statistical
  • Female
  • Hemorrhage/chemically induced
  • Humans
  • Kaplan-Meiers Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction/epidemiology
  • Platelet Aggregation Inhibitors/administration & dosage/adverse
  • effects/*therapeutic use
  • Proportional Hazards Models
  • Recurrence/prevention & control
  • Risk
  • Stroke/*drug therapy/epidemiology/prevention & control
  • Ticlopidine/adverse effects/*analogs & derivatives/therapeutic use
  • Vascular Diseases/mortality

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Diener, H. C.University of Duisberg-Essen, Essen, Germany (författare)
  • Yusuf, S.McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (författare)
  • Cotton, D.Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States (författare)
  • Ounpuu, S.Boehringer Ingelheim, Burlington, ON, Canada (författare)
  • Lawton, W. A.Boehringer Ingelheim, Bracknell, United Kingdom (författare)
  • Palesch, Y.Medical University of Soudi Carolina, Charleston, United States (författare)
  • Martin, R. H.Medical University of Soudi Carolina, Charleston, United States,Boehringer Ingelheim, Stockholm, Sweden (författare)
  • Albers, G. W.Stanford University, Medical Center, Palo Alto, CA, United States (författare)
  • Bath, P.University of Nottingham, Nottingham, United Kingdom (författare)
  • Bornstein, N.Ichilov Medical Center, Tel Aviv, Israel (författare)
  • Chan, B. P.National University Hospital, Singapore, Singapore,St. Johns's Medical College, Bangalore, India (författare)
  • Chen, S. T.Chang Gung Memorial Hospital, Tapei, Taiwan (författare)
  • Cunha, L.Hospitais da Universidade de Coimbra, Coimbra, Portugal (författare)
  • Dahlöf, Björn,1953Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine,Sahlgrenska University Hospital-Östra, Göteborg, Sweden(Swepub:gu)xdahbj (författare)
  • De Keyser, J.University Medical Center Groningen, Groningen, Netherlands (författare)
  • Donnan, G. A.University of Melbourne, Heidelberg West, Australia (författare)
  • Estol, C.Neurological Center for Treatment and Research, Buenos Aires, Argentina (författare)
  • Gorelick, P.University of Illinois, Chicago, United States (författare)
  • Gu, V.Boehringer Ingelheim Shanghai Pharmaceuticals, Shanghai, China (författare)
  • Hermansson, K. (författare)
  • Hilbrich, L.Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States (författare)
  • Kaste, M.Helsinki University, Central Hospital, Helsinki, Finland (författare)
  • Lu, C.Huashan Hospital, Shanghai, China (författare)
  • Machnig, T.Boehringer Ingelheim, Ingelheim, Germany (författare)
  • Pais, P. (författare)
  • Roberts, R. (författare)
  • Skvortsova, V.Russian State Medical University, Moscow, Russian Federation (författare)
  • Teal, P.University of British Columbia, Vancouver, Canada (författare)
  • Toni, D.University La Sapienza, Rome, Italy (författare)
  • VanderMaelen, C.Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States (författare)
  • Voigt, T.Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States (författare)
  • Weber, M.SUNY Downstate College of Medicine, New York, United States (författare)
  • Yoon, B. W.Seoul National University Hospital, Seoul, South Korea (författare)
  • von Euler, Mia,1967-(författare)
  • Miller School of Medicine, University of Miami, Miami, United States; Miller School of Medicine, University of Miami, Miami, United StatesMcMaster University, Hamilton, ON, Canada (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:New England Journal of MedicineBoston : Massachusetts medical society359:12, s. 1238-511533-44060028-4793

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