BMJ  2007;334:901 (28 April), doi:10.1136/bmj.39160.702188.AD

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Dipyridamole with aspirin is better than aspirin alone in preventing vascular events after ischaemic stroke or TIA

Cathie Sudlow, clinical senior lecturer and honorary consultant neurologist

Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU

cathie.sudlow@ed.ac.uk

The first 150 words of the full text of this article appear below.

The clinical problem

After an ischaemic stroke or transient ischaemic attack (TIA), patients are at high risk of subsequent stroke and other vascular events, such as myocardial infarction. Strategies to prevent vascular events (stroke, myocardial infarction, or vascular death) in such patients include using aspirin, which is the most widely tested single antiplatelet drug for this purpose.1 2 Good evidence now exists, however, that adding dipyridamole to aspirin further reduces the risk in patients who have had an ischaemic stroke or transient ischaemic attack.


• In patients with a prior ischaemic stroke or transient ischaemic attack, adding the antiplatelet drug dipyridamole (modified release formulation, 200 mg twice daily) to aspirin reduces the relative risk of vascular events (stroke, myocardial infarction, or vascular death) by a fifth
• In patients already receiving current secondary preventive treatment, the average annual risk of a vascular event is no more than 5%; adding dipyridamole prevents one further vascular . . . [Full text of this article]


The evidence for change

Barriers to change

How should we change our practice?


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Combination shows no advantage over aspirin alone
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This article has been cited by other articles:

  • Sudlow, C (2008). Preventing further vascular events after a stroke or transient ischaemic attack: an update on medical management. PN 8: 141-157 [Abstract] [Full text]  
  • Gogol, M. (2007). Combination shows no advantage over aspirin alone. BMJ 334: 1020-1020 [Full text]  

Rapid Responses:

Read all Rapid Responses

No advantage of dipyridamole and aspirin versus aspirin alone
Manfred Gogol
bmj.com, 29 Apr 2007 [Full text]
Don't forget the bleeding risk with Dipyridamole
Brendan A McGrath
bmj.com, 6 May 2007 [Full text]
No change to recommend
Erika Baum
bmj.com, 21 May 2007 [Full text]
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