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Aspirin and extende...
Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke
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- Sacco, R. L. (author)
- 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
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- Diener, H. C. (author)
- University of Duisberg-Essen, Essen, Germany
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- Yusuf, S. (author)
- McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
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- Cotton, D. (author)
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States
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- Ounpuu, S. (author)
- Boehringer Ingelheim, Burlington, ON, Canada
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- Lawton, W. A. (author)
- Boehringer Ingelheim, Bracknell, United Kingdom
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- Palesch, Y. (author)
- Medical University of Soudi Carolina, Charleston, United States
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- Martin, R. H. (author)
- Medical University of Soudi Carolina, Charleston, United States,Boehringer Ingelheim, Stockholm, Sweden
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- Albers, G. W. (author)
- Stanford University, Medical Center, Palo Alto, CA, United States
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- Bath, P. (author)
- University of Nottingham, Nottingham, United Kingdom
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- Bornstein, N. (author)
- Ichilov Medical Center, Tel Aviv, Israel
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- Chan, B. P. (author)
- National University Hospital, Singapore, Singapore,St. Johns's Medical College, Bangalore, India
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- Chen, S. T. (author)
- Chang Gung Memorial Hospital, Tapei, Taiwan
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- Cunha, L. (author)
- Hospitais da Universidade de Coimbra, Coimbra, Portugal
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- Dahlöf, Björn, 1953 (author)
- Gothenburg 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
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- De Keyser, J. (author)
- University Medical Center Groningen, Groningen, Netherlands
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- Donnan, G. A. (author)
- University of Melbourne, Heidelberg West, Australia
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- Estol, C. (author)
- Neurological Center for Treatment and Research, Buenos Aires, Argentina
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- Gorelick, P. (author)
- University of Illinois, Chicago, United States
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- Gu, V. (author)
- Boehringer Ingelheim Shanghai Pharmaceuticals, Shanghai, China
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Hermansson, K. (author)
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- Hilbrich, L. (author)
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States
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- Kaste, M. (author)
- Helsinki University, Central Hospital, Helsinki, Finland
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- Lu, C. (author)
- Huashan Hospital, Shanghai, China
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- Machnig, T. (author)
- Boehringer Ingelheim, Ingelheim, Germany
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Pais, P. (author)
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Roberts, R. (author)
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- Skvortsova, V. (author)
- Russian State Medical University, Moscow, Russian Federation
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- Teal, P. (author)
- University of British Columbia, Vancouver, Canada
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- Toni, D. (author)
- University La Sapienza, Rome, Italy
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- VanderMaelen, C. (author)
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States
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- Voigt, T. (author)
- Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, United States
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- Weber, M. (author)
- SUNY Downstate College of Medicine, New York, United States
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- Yoon, B. W. (author)
- Seoul National University Hospital, Seoul, South Korea
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von Euler, Mia, 1967- (author)
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(creator_code:org_t)
- Boston : Massachusetts medical society, 2008
- 2008
- English.
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In: New England Journal of Medicine. - Boston : Massachusetts medical society. - 1533-4406 .- 0028-4793. ; 359:12, s. 1238-51
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
Close
- 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.)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Keyword
- 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
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Sacco, R. L.
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Diener, H. C.
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Yusuf, S.
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Cotton, D.
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Ounpuu, S.
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Lawton, W. A.
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show more...
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Palesch, Y.
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Martin, R. H.
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Albers, G. W.
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Bath, P.
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Bornstein, N.
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Chan, B. P.
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Chen, S. T.
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Cunha, L.
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Dahlöf, Björn, 1 ...
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De Keyser, J.
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Donnan, G. A.
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Estol, C.
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Gorelick, P.
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Gu, V.
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Hermansson, K.
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Hilbrich, L.
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Kaste, M.
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Lu, C.
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Machnig, T.
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Pais, P.
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Roberts, R.
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Skvortsova, V.
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Teal, P.
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Toni, D.
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VanderMaelen, C.
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Voigt, T.
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Weber, M.
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Yoon, B. W.
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von Euler, Mia, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and General Practice
- Articles in the publication
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New England Jour ...
- By the university
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University of Gothenburg
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Örebro University
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Karolinska Institutet