| Authors |
| Esprit Study Group |
| Title |
| Aspirin plus dipyridamole versus aspirin alone after cerebral ischemia of arterial origin (ESPRIT): randomised controlled trial |
| References |
| Lancet 2006;367:1665-1673. |
| Background |
| There is controversy on whether the combination of dipyridamole and aspirin is better than aspirin alone for the secondary prevention of vascular events after ischemic stroke of arterial origin. |
| Purpose |
| To compare dipyridamole and aspirin with aspirin alone in patients with transient ischemic attack or minor ischemic stroke of arterial origin. |
| Design |
- Open-label, randomized, controlled trial (event adjudication was blinded)
- 2,730 patients with history of transient ischemic attack (TIA) or minor ischemic stroke (grade ≤ 3 on the modified Rankin scale), within 6 months. Ischemic event was presumed arterial origin.
|
| Exclusion Criteria |
| None. |
| Follow-Up |
| 3.5 years (mean) |
| Treatment Regimen |
- Aspirin (30-325 mg/day) and dipyridamole 200 mg bid versus Aspirin 30-325 mg/day (mean aspirin dose in both groups was 75 mg/day)
- Anticoagulation (target INR 2.0-3.0) versus aspirin
|
| Results |
| Primary Endpoints: Composite of death from all vascular causes, non-fatal stroke, non-fatal myocardial infarction, non-fatal major bleeding. There was a discontinuation rate of 34% in the aspirin/dipyridamole group mainly due to headache. |
| Summary |
| The combination of aspirin and dipyridamole reduced the relative risk of the primary composite outcome of nonfatal stroke, nonfatal MI, vascular death, or nonfatal major bleed by 20% compared to aspirin alone. |
| Implications |
| None. |
| Related Figures |
| [7] |