In secondary (non-afib) stroke prevention, current guidelines recommend antiplatelet therapy (guideline) but do not give a prefence to which type. In the first head to head trial, the RCT PRoFESS Trial (abstract), randomized 20,332 patients to clopidogrel or ASA-dipyridamole within 4 months of an ischemic stroke. There was no significant difference in recurrent stroke, MI, or death between the groups. This study indicates there is not much difference in efficacy between them, and an accompanying editorial satirically states, in haiku “For stroke prevention / use an antiplatelet drug. / Treat hypertension.” (editorial).
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