Trial reportLancet (London, England)2018
Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial.
Trial report in Lancet (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 11 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 11 syntheses or guidelines pooled it, 177 citations in OpenAlex.
- Effectiveness and safety of different antiplatelet therapies for minor ischemic stroke or high-risk transient ischemic attack: a systematic review and network meta-analysis.International journal of clinical pharmacy · 2025Pooled it
- The reporting of health systems data use in primary results publications of clinical trials: a systematic review.Trials · 2025Pooled it
- Tailoring dual antiplatelet therapy for stroke prevention: a meta-analysis of timing, duration, regimen, and stroke subtypes.Frontiers in pharmacology · 2025Pooled it
- European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke.European stroke journal · 2024Guideline
- Contemporary antiplatelet therapy for secondary stroke prevention: a narrative review of current literature and guidelines.Stroke and vascular neurology · 2022Pooled it
- The role ofExpert review of clinical pharmacology · 2022Pooled it
- Oral antiplatelet therapy for acute ischaemic stroke.The Cochrane database of systematic reviews · 2022Pooled it
- 2022 Update of the Korean Clinical Practice Guidelines for Stroke: Antithrombotic Therapy for Patients with Acute Ischemic Stroke or Transient Ischemic Attack.Journal of stroke · 2022Guideline
- Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack.The Cochrane database of systematic reviews · 2020Pooled 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
- Dual versus mono antiplatelet therapy for acute non-cardioembolic ischaemic stroke or transient ischaemic attack: a systematic review and meta-analysis.Stroke and vascular neurology · 2018Pooled it
- Effect of prior antiplatelet therapy on recurrence in patients with acute cerebral ischaemia: data from the triple antiplatelets for reducing dependency after ischaemic stroke (TARDIS) randomised trial.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Trial
- Colchicine in patients with acute ischaemic stroke or transient ischaemic attack (CHANCE-3): multicentre, double blind, randomised, placebo controlled trial.BMJ (Clinical research ed.) · 2024Trial
- Differential effect of ticagrelor versus clopidogrel by homocysteine levels on risk of recurrent stroke: a post hoc analysis of the CHANCE-2 trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Trial
- Enhancing open clinical trials through blinded evaluations: an exploration with diabetic foot infections.Trials · 2023Trial
- Bleeding with intensive versus guideline antiplatelet therapy in acute cerebral ischaemia.Scientific reports · 2023Trial
- Impact of body mass index on efficacy and safety of ticagrelor versus clopidogrel in patients with minor stroke or transient ischemic attack.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Trial
- Naoxintong Capsule for Secondary Prevention of Ischemic Stroke: A Multicenter, Randomized, and Placebo-Controlled Trial.Chinese journal of integrative medicine · 2022Trial
- Acute Aspirin Plus Cilostazol Dual Therapy for Noncardioembolic Stroke Patients Within 48 Hours of Symptom Onset.Journal of the American Heart Association · 2019Trial
- Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA.The New England journal of medicine · 2018 · on this mapTrial
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
23 authors at 9 institutions in 3 countries.
Funding
Abstract
backgroundIntensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy.
methodsWe did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388.
findings3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67-1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05-3·16, p<0·0001).
interpretationAmong patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice.
fundingNational Institutes of Health Research Health Technology Assessment Programme, British Heart Foundation.
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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.