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Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke
DC Field | Value | Language |
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dc.contributor.author | Sacco, Ralph L | - |
dc.contributor.author | Diener, Hans-Christoph | - |
dc.contributor.author | Yusuf, Salim | - |
dc.contributor.author | Cotton, Daniel | - |
dc.contributor.author | Ounpuu, Stephanie | - |
dc.contributor.author | Lawton, William A | - |
dc.contributor.author | Palesch, Yuko | - |
dc.contributor.author | Martin, Renee H | - |
dc.contributor.author | Albers, Gregory W | - |
dc.contributor.author | Bath, Philip | - |
dc.contributor.author | Bornstein, Natan | - |
dc.contributor.author | Chan, Bernard P L | - |
dc.contributor.author | Chen, Sien-Tsong | - |
dc.contributor.author | Cunha, Luis | - |
dc.contributor.author | Dahlof, Bjorn | - |
dc.contributor.author | De Keyser, Jacques | - |
dc.contributor.author | Donnan, Geoffrey A | - |
dc.contributor.author | Estol, Conrado | - |
dc.contributor.author | Gorelick, Philip | - |
dc.contributor.author | Gu, Vivian | - |
dc.contributor.author | Hermansson, Karin | - |
dc.contributor.author | Hilbrich, Lutz | - |
dc.contributor.author | Kaste, Markku | - |
dc.contributor.author | Lu, Chuanzhen | - |
dc.contributor.author | Machnig, Thomas | - |
dc.contributor.author | Pais, Prem | - |
dc.contributor.author | Roberts, Robin | - |
dc.contributor.author | Skvortsova, Veronika | - |
dc.contributor.author | Teal, Philip | - |
dc.contributor.author | Toni, Danilo | - |
dc.contributor.author | Vandermaelen, Cam | - |
dc.contributor.author | Voigt, Thor | - |
dc.contributor.author | Weber, Michael | - |
dc.contributor.author | Yoon, Byung-Woo | - |
dc.date.accessioned | 2010-07-06T06:35:17Z | - |
dc.date.available | 2010-07-06T06:35:17Z | - |
dc.date.issued | 2008-08-30 | - |
dc.identifier.citation | N Engl J Med. 2008;359(12):1238-1251 | en |
dc.identifier.issn | 1533-4406 (Electronic) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18753638 | - |
dc.identifier.uri | http://content.nejm.org/cgi/reprint/359/12/1238.pdf | - |
dc.identifier.uri | https://hdl.handle.net/10371/68329 | - |
dc.description.abstract | 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.) | en |
dc.language.iso | en | en |
dc.publisher | Massachusetts Medical Society | en |
dc.subject | Aged | en |
dc.subject | Angiotensin-Converting Enzyme Inhibitors/therapeutic use | en |
dc.subject | Aspirin/*administration & dosage/adverse effects | en |
dc.subject | Benzimidazoles/therapeutic use | en |
dc.subject | Benzoates/therapeutic use | en |
dc.subject | Brain Ischemia/epidemiology/prevention & control | en |
dc.subject | Delayed-Action Preparations | en |
dc.subject | Dipyridamole/adverse effects/*therapeutic use | en |
dc.subject | Double-Blind Method | en |
dc.subject | Drug Therapy, Combination | en |
dc.subject | Factor Analysis, Statistical | en |
dc.subject | Female | en |
dc.subject | Hemorrhage/chemically induced | en |
dc.subject | Humans | en |
dc.subject | Kaplan-Meiers Estimate | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Myocardial Infarction/epidemiology | en |
dc.subject | Platelet Aggregation Inhibitors/administration & dosage/adverse effects/*therapeutic use | en |
dc.subject | Proportional Hazards Models | en |
dc.subject | Recurrence/prevention & control | en |
dc.subject | Risk | en |
dc.subject | Stroke/*drug therapy/epidemiology/prevention & control | en |
dc.subject | Ticlopidine/adverse effects/*analogs & derivatives/therapeutic use | en |
dc.subject | Vascular Diseases/mortality | en |
dc.title | Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 윤병우 | - |
dc.identifier.doi | 10.1056/NEJMoa0805002 | - |
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