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In 2013, the study of clopidogrel in the treatment of high-risk patients with acute non-disabling cerebrovascular events (CHANCE study) led by Professor Wang Yongjun's team from Tiantan Hospital was published in the New England Journal of Medicine NEJM.
Vascular This study established the double-antibody therapy (aspirin plus clopidogrel) for small stroke short in the preventive effects of recurrent stroke.
JAMA
The results showed that according to the results of DWI imaging, compared with those with negative imaging, the risk of recurrence of stroke in patients with multifocal infarction and single infarction increased by 4.
According to the results of DWI imaging, compared with patients with negative imaging, the risk of stroke recurrence in patients with multifocal infarction and single infarction increased by 4.
The combination of clopidogrel and aspirin does not increase the risk of moderate to severe bleeding in patients with multifocal infarction.
DWI diagram of stroke infarction
DWI diagram of stroke infarctionSo, after 3 years, what is the real evidence for the efficacy of double or monoclonal antibody treatment for patients with recurrent stroke or transient ischemic attack (TIA)? To this end, researchers from the Institute of Neurology at the University of Illinois in the United States conducted a relevant summary and conducted a meta-analysis of all major studies comparing the effectiveness and safety of double antibodies and monotherapy for secondary prevention of recurrent stroke or TIA.
The main result of the study is the combined result of stroke onset, TIA, acute coronary syndrome, and death from various causes.
2
A total of 27358 patients were included and analyzed.
2 as compared with monotherapy, double antibody therapy of recurrent stroke is reduced by 29% (RR = 0.
Compared with single-agent therapy, double-antibody therapy for ≤30 days increased the risk of bleeding by nearly double (RR=1.
Comparison of monoclonal antibodies and double antibodies in preventing stroke recurrence in patients with multifocal infarction and stroke
Comparison of monoclonal antibodies and double antibodies in preventing stroke recurrence in patients with multifocal infarction and strokeIt can be seen that compared with single-agent therapy, the dual-antibody therapy of aspirin plus clopidogrel with a treatment time of 30 days reduces the risk of stroke recurrence and compound events, and does not increase the risk of major bleeding.
It can be seen that compared with single-agent therapy, the dual-antibody therapy of aspirin plus clopidogrel with a treatment time of 30 days reduces the risk of stroke recurrence and compound events, and does not increase the risk of major bleeding.
references:
Trifan G, Gorelick PB, Testai FD.
Efficacy and Safety of Using Dual Versus Monotherapy Antiplatelet Agents in Secondary Stroke Prevention: Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.
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