- Clopidogrel and aspirin monotherapy are equally safe and effective for secondary prevention of recurrent cerebrovascular attack following previous ischemic stroke in patients with type 2 diabetes (T2D).
Why this matters
- Aspirin is recommended as initial treatment for secondary prevention of recurrent ischemic stroke in patients with T2D, but some cannot tolerate aspirin.
- Systematic review, meta-analysis of 6 studies involving 9218 participants with T2D who had previous ischemic stroke, with 4917 taking aspirin and 4301 taking clopidogrel.
- Funding: None.
- No significant difference in recurrent stroke (risk ratio [RR], 0.79; 95% CI, 0.61-1.02; P=.07) with aspirin vs clopidogrel monotherapy for secondary prevention of recurrent cerebrovascular attack following previous ischemic stroke.
- Risks between treatment groups were similar for fatal stroke (RR, 0.88; P=.76), cerebral hemorrhage (RR, 0.65; P=.12), myocardial infarction (RR, 0.88; P=.71), and mortality (RR, 1.07; P=.44).
- Total participant number might have yielded insufficient power.
- Limited number of studies on this specific topic.
- Only 2 studies had assessed fatal stroke and myocardial infarction.
- Other important outcomes and adverse drug events including gastrointestinal bleeding, abdominal pain, melena, and other bleeding not reported.
- Data from randomized and observational studies combined.