What do the results of the PRoFESS trial teach us?

摘要

Antiplatelet therapy is recommended for all patients with transient ischaemic attack (TIA) and ischaemic stroke of arterial origin because it reduces the long-term risk of subsequent stroke, myocardial infarction, or vascular death by about a fifth. But what is the optimum antiplatelet regimen? Although aspirin is the most widely prescribed antiplatelet drug (because it is widely available, reasonably safe, and affordable), it is only modestly effective. Compared with placebo (or no aspirin), aspirin only reduces the relative risk (RRR) of major vascular events by about 13% (95% Cl 6% to 19%).Two antiplatelet regimens are superior to aspirin: clopidogrel and the combination of aspirin and extended-release dipyridamole.