A minor stroke or transient ischemic attack (mini-stroke or TIA) is a frightening event. It’s often followed within a few days or weeks by a more serious stroke. Rapid treatment of a minor stroke or TIA with aspirin and clopidogrel (Plavix) can help prevent a repeat stroke.
The finding comes from a Chinese study published in the New England Journal of Medicine. The study enrolled more than 5,000 people with underlying stroke risk factors, relatively minor strokes, or major TIAs (but not people with quickly passing dizziness or brief visual or sensory events).
The findings have major implications for people at high risk of a devastating second stroke. Aspirin helps reduce this risk, but only slightly.
But when begun within 24 hours of symptoms, the dual treatment with aspirin and clopidogrel cut stroke risk by nearly a third. It did not increase the risk of dangerous bleeding. Compared with aspirin alone, the treatment would prevent one stroke for every 29 people treated.
Stroke risk is highest in the days following a minor stroke or TIA. And since using both aspirin and clopidogrel increases bleeding risk, treatment should last no more than 90 days.