Which Is the Best Antiplatelet Therapy?
At the present time aspirin, dipyridamole and ticlopidine are mainly available. Clopidogrel. just licensed, is now becoming available in several countries. Most studies have been done with aspirin. They demonstrated a positive effect by 22% for all doses from 75 to 1,300 mg/day. A recent study, the European Stroke Prevention Study 2 (ESPS-2) compared in 3 parallel groups aspirin 50 mg/day, dipyridamole 400 mg/day and both aspirin + dipyridamole. It showed a comparable effect of each separate drug and an additive effect of both together. However, this study can be criticized because it used small doses of aspirin which may be less effective than moderate or high doses. Indeed, in a first large combination study (ESPS-1) aspirin was used at a higher dose. Also, previous studies failed to show an additive effect of dipyridamole to aspirin. Current users of low dose ( 50 mg/day doses of aspirin is unknown. In the Ticlopidine Aspirin Stroke Study (TASS), aspirin 1,300 mg was compared to tic
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