Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk
Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient ischemic attack or minor stroke of presumed arterial origin and to perform subgroup analyses to identify patients that might benef...
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| Format: | Article |
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BMJ
2008
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| Online Access: | https://eprints.nottingham.ac.uk/969/ |
| _version_ | 1848790512384868352 |
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| author | Halkes, P.H.A. Gray, Laura J. Bath, Philip M.W. Diener, Hans-Christoph Guiraud-Chaumeil, B. |
| author_facet | Halkes, P.H.A. Gray, Laura J. Bath, Philip M.W. Diener, Hans-Christoph Guiraud-Chaumeil, B. |
| author_sort | Halkes, P.H.A. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient
ischemic attack or minor stroke of presumed arterial origin and to perform subgroup analyses to identify patients that might benefit most from secondary prevention with A+D.
Data sources: The previously published meta-analysis of individual patient data was updated with data from ESPRIT (N=2,739); trials without data on the comparison of A+D versus ASA were excluded.
Review methods: A meta-analysis was performed using Cox regression, including several subgroup analyses and following baseline risk stratification.
Results: A total of 7,612 patients (5 trials) were included in the analyses, 3,800 allocated to A+D and 3,812 to ASA alone. The trial-adjusted hazard ratio for the composite event of vascular death, non-fatal myocardial infarction and non-fatal stroke was 0.82 (95% confidence interval 0.72-0.92). Hazard ratios did not differ in subgroup analyses based on age, sex, qualifying event, hypertension, diabetes, previous stroke, ischemic heart disease,
aspirin dose, type of vessel disease and dipyridamole formulation, nor across baseline risk strata as assessed with two different risk scores. A+D were also more effective than ASA alone in preventing recurrent stroke, HR 0.78 (95% CI 0.68 – 0.90).
Conclusion: The combination of aspirin and dipyridamole is more effective than aspirin alone in patients with TIA or ischemic stroke of presumed arterial origin in the secondary
prevention of stroke and other vascular events. This superiority was found in all subgroups and was independent of baseline risk. ---------------------------7dc3521430776
Content-Disposition: form-data; name="c14_creators_1_name_family"
Halkes |
| first_indexed | 2025-11-14T18:13:48Z |
| format | Article |
| id | nottingham-969 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T18:13:48Z |
| publishDate | 2008 |
| publisher | BMJ |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-9692020-05-04T20:27:10Z https://eprints.nottingham.ac.uk/969/ Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk Halkes, P.H.A. Gray, Laura J. Bath, Philip M.W. Diener, Hans-Christoph Guiraud-Chaumeil, B. Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient ischemic attack or minor stroke of presumed arterial origin and to perform subgroup analyses to identify patients that might benefit most from secondary prevention with A+D. Data sources: The previously published meta-analysis of individual patient data was updated with data from ESPRIT (N=2,739); trials without data on the comparison of A+D versus ASA were excluded. Review methods: A meta-analysis was performed using Cox regression, including several subgroup analyses and following baseline risk stratification. Results: A total of 7,612 patients (5 trials) were included in the analyses, 3,800 allocated to A+D and 3,812 to ASA alone. The trial-adjusted hazard ratio for the composite event of vascular death, non-fatal myocardial infarction and non-fatal stroke was 0.82 (95% confidence interval 0.72-0.92). Hazard ratios did not differ in subgroup analyses based on age, sex, qualifying event, hypertension, diabetes, previous stroke, ischemic heart disease, aspirin dose, type of vessel disease and dipyridamole formulation, nor across baseline risk strata as assessed with two different risk scores. A+D were also more effective than ASA alone in preventing recurrent stroke, HR 0.78 (95% CI 0.68 – 0.90). Conclusion: The combination of aspirin and dipyridamole is more effective than aspirin alone in patients with TIA or ischemic stroke of presumed arterial origin in the secondary prevention of stroke and other vascular events. This superiority was found in all subgroups and was independent of baseline risk. ---------------------------7dc3521430776 Content-Disposition: form-data; name="c14_creators_1_name_family" Halkes BMJ 2008-11 Article PeerReviewed Halkes, P.H.A., Gray, Laura J., Bath, Philip M.W., Diener, Hans-Christoph and Guiraud-Chaumeil, B. (2008) Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk. Journal of Neurology, Neurosurgery and Psychiatry, 79 (11). pp. 1218-1223. ISSN 0022-3050 http://jnnp.bmj.com/content/79/11/1218.full doi:10.1136/jnnp.2008.143875 doi:10.1136/jnnp.2008.143875 |
| spellingShingle | Halkes, P.H.A. Gray, Laura J. Bath, Philip M.W. Diener, Hans-Christoph Guiraud-Chaumeil, B. Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk |
| title | Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk |
| title_full | Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk |
| title_fullStr | Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk |
| title_full_unstemmed | Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk |
| title_short | Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk |
| title_sort | dipyridamole plus aspirin versus aspirin alone in the secondary prevention after tia or stroke: a meta-analysis by risk |
| url | https://eprints.nottingham.ac.uk/969/ https://eprints.nottingham.ac.uk/969/ https://eprints.nottingham.ac.uk/969/ |