To determine optiminal therapy to prevent recurrent stroke
- Aspirin (stroke prevention) Drug
Intervention Desc: Antiplatelet agent; inhibits thromboxane A2
- Clopidogrel (Plavix®)Drug
Other Names: Plavix, Clodelib, Clovelen Intervention Desc: Antiplatelet agent
- Dipyridamole (Persantine®)Drug
Intervention Desc: Platelet aggregation inhibitor
Interventional, randomised double-blinded single-centre study.
Patients randomised to aspirin and dipyridamole will continue with this treatment long-term as this is the standard treatment regimen. Patients randomised to aspirin and clopidogrel will continue will this treatment for one month, and then will revert to the aspirin and dipyridamole combination long-term. Patients will be followed up for recurrent strokes and TIA up until one month, or until carotid endarterectomy or stenting is performed.
This is a pragmatic study to compare two anti-platelet regimes used in clinical practice. The loading dose of clopidogrel of 300 mg followed by 75 mg a day has been shown to have a rapid efficacy with maximal effect on the rate of embolisation within 24 hours. Dipyridamole SR has been shown to demonstrate maximal platelet concentrations within two hours and a loading dose is therefore unnecessary.
|Type||Measure||Time Frame||Safety Issue|
|Primary||The number of embolic signals (using international consensus criteria) detected during transcranial doppler recording from ipsilateral middle cerebral artery at 48 hours after study entry.|
|Secondary||No secondary outcome measures.|