Trial reportThe New England journal of medicine2008
Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke.
Trial report in The New England journal of medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 259 papers, 20 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PRoFESS - Prevention Regimen For Effectively Avoiding Second Strokes: A Double-blind, Active and Placebo Controlled Study of Aggrenox vs. Clopidogrel, With and Without Micardis
Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial
Who cites it
259 citing papers in PubMed, 20 syntheses or guidelines pooled it, 965 citations in OpenAlex.
- The bleeding costs of intensive vs. less intensive antithrombotic strategies: a meta-regression analysis.European heart journal. Quality of care & clinical outcomes · 2026Pooled it
- Dual antiplatelet therapy use after non-cardioembolic ischemic stroke or transient ischemic attack: a meta-analysis of trials and cohort studies.Frontiers in neurology · 2025Pooled it
- Clinical and cost-effectiveness of clopidogrel resistance genotype testing after ischaemic stroke or transient ischaemic attack: a systematic review and economic model.Health technology assessment (Winchester, England) · 2024Pooled it
- European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke.European stroke journal · 2024Guideline
- Hypoglycemia as a potential risk for patients taking clopidogrel: A systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Contemporary antiplatelet therapy for secondary stroke prevention: a narrative review of current literature and guidelines.Stroke and vascular neurology · 2022Pooled it
- The Importance of Platelets Response during Antiplatelet Treatment after Ischemic Stroke-Between Benefit and Risk: A Systematic Review.International journal of molecular sciences · 2022Pooled it
- Pooled it
- Clopidogrel and aspirin after ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis of randomized clinical trials.Journal of thrombosis and thrombolysis · 2019Pooled it
- Benefits and Risks of Clopidogrel vs. Aspirin Monotherapy after Recent Ischemic Stroke: A Systematic Review and Meta-Analysis.Cardiovascular therapeutics · 2019Pooled it
- Clopidogrel plus aspirin versus aspirin alone for acute minor ischaemic stroke or high risk transient ischaemic attack: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2018Pooled it
- Early time course of major bleeding on antiplatelet therapy after TIA or ischemic stroke.Neurology · 2018Pooled it
- Comparative Efficacy and Safety of Nine Anti-Platelet Therapies for Patients with Ischemic Stroke or Transient Ischemic Attack: a Mixed Treatment Comparisons.Molecular neurobiology · 2017Pooled it
- Guideline
- Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials.Lancet (London, England) · 2016Pooled it
- Pooled it
- Recurrent vascular events in lacunar stroke patients with metabolic syndrome and/or diabetes.Neurology · 2015Pooled it
- Interventions for deliberately altering blood pressure in acute stroke.The Cochrane database of systematic reviews · 2014Pooled it
- European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).International journal of behavioral medicine · 2012Guideline
- Adenosine-diphosphate (ADP) receptor antagonists for the prevention of cardiovascular disease in type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2012Pooled it
199 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
35 authors at 13 institutions in 9 countries.
Funding
Abstract
backgroundRecurrent 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.
methodsIn 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.
resultsA 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).
conclusionsThe 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.)
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.