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A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke

  • Authors:
    • Xingjian Zhou
    • Jing Tian
    • Ming Zhen Zhu
    • Colin K. He
  • View Affiliations / Copyright

    Affiliations: Department of Endocrinology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China, Orient Health Care, StegoTech LLC, King of Prussia, PA 19406, USA
    Copyright: © Zhou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 324-332
    |
    Published online on: May 17, 2017
       https://doi.org/10.3892/etm.2017.4459
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Abstract

The use of antiplatelet agents in patients with ischemic stroke is recommended. In this study, we compared the efficacy and safety of the treatment of clopidogrel plus aspirin (ASA) and that of ASA alone in patients with mild stroke/transient ischemic attack (TIA). Randomized controlled trial (RCT) studies of Clop + ASA vs. ASA therapy in the patients with minor stroke/TIA were identified by electronic bibliographic searches. The primary result was recurrent stroke, while myocardial infarction (MI) as well as vascular mortalities were the secondary result, and major hemorrhagic events were the safety result. A comparative analysis of binary outcomes was performed on the treatment groups, with the employment of fixed effect models and the measurement of risk ratios (95% CI). Five RCT studies involving 9,527 patients were included. Compared with the group with ASA treatment, there was significant reduction in the incidence of recurrent stroke in the group with Clop + ASA (RR=0.76, 95% CI=0.67‑0.87, P<0.0001), and there was no significant increase in the incidence of vascular mortalities and MI (RR=1.08, 95% CI=0.83-1.41, P=0.56) and no significant change in major hemorrhagic events (RR=1.55, 95% CI=0.72‑3.36, P=0.26). Therefore, the treatment with Clop + ASA seems safe as well as effective for decreasing stroke recurrence. In addition, this is related to a statistically insignificant trend in increasing vascular mortalities, MI, and primary hemorrhagic events. These findings need to be confirmed in prospective studies.
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Copy and paste a formatted citation
Spandidos Publications style
Zhou X, Tian J, Zhu MZ and He CK: A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke. Exp Ther Med 14: 324-332, 2017.
APA
Zhou, X., Tian, J., Zhu, M.Z., & He, C.K. (2017). A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke. Experimental and Therapeutic Medicine, 14, 324-332. https://doi.org/10.3892/etm.2017.4459
MLA
Zhou, X., Tian, J., Zhu, M. Z., He, C. K."A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke". Experimental and Therapeutic Medicine 14.1 (2017): 324-332.
Chicago
Zhou, X., Tian, J., Zhu, M. Z., He, C. K."A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke". Experimental and Therapeutic Medicine 14, no. 1 (2017): 324-332. https://doi.org/10.3892/etm.2017.4459
Copy and paste a formatted citation
x
Spandidos Publications style
Zhou X, Tian J, Zhu MZ and He CK: A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke. Exp Ther Med 14: 324-332, 2017.
APA
Zhou, X., Tian, J., Zhu, M.Z., & He, C.K. (2017). A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke. Experimental and Therapeutic Medicine, 14, 324-332. https://doi.org/10.3892/etm.2017.4459
MLA
Zhou, X., Tian, J., Zhu, M. Z., He, C. K."A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke". Experimental and Therapeutic Medicine 14.1 (2017): 324-332.
Chicago
Zhou, X., Tian, J., Zhu, M. Z., He, C. K."A systematic review and meta-analysis of published randomized controlled trials of combination of clopidogrel and aspirin in transient ischemic attack or minor stroke". Experimental and Therapeutic Medicine 14, no. 1 (2017): 324-332. https://doi.org/10.3892/etm.2017.4459
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