Context
The crude prevalence of stroke is high in Assiut. Most patients arrived beyond the approved time for reperfusion therapy due to a lack of health facilitation and instead received antiplatelet therapy. There is controversy about the safety and efficacy of single or dual antiplatelet therapy in the treatment of acute ischemic stroke (AIS).
Aims
Evaluation of the safety and efficacy of aspirin and clopidogrel either as a monotherapy or combined therapy in patients presenting with AIS within 24 h of symptom onset.
Settings and design
A randomized double-blind controlled trial involving patients with AIS within 24 h of symptom onset and are not eligible for any revascularization therapy.
Patients and methods
Random allocation of 315 patients into three groups with a ratio of 1:1:1 to be administered either combined aspirin and clopidogrel or aspirin plus placebo or placebo plus clopidogrel.
Statistical analysis used
SPSS, version 20, was used for the management and analysis of data, test, and analysis of variance test.
Results
Stroke recurrence was insignificantly ( = 0.40) higher in the aspirin group (11.5%) in comparison to the clopidogrel group (6.7%) and combined group (3.8%) but a significant ( = 0.01) higher intracranial hemorrhage risk was noticed in patients who received combined therapy (2.9%).
Conclusion
Patients with AIS who administered combined therapy had an insignificant low risk of recurrent ischemic stroke but had a highly significant risk of severe hemorrhage than patients who administered clopidogrel or aspirin alone.