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NICE has published guidance on clopidogrel and modified-release dipyridamole for the secondary prevention of strokes and heart attacks.

In its technology appraisal, NICE ruled that patients who had had a stroke or heart attack, or who had been diagnosed with symptomatic peripheral arterial disease, should be prescribed the drugs in certain circumstances.

For patients who had suffered a stroke, NICE said MR dipyridamole should be used in combination with aspirin for two years from the most recent event.

NICE said clopidogrel should be used on its own within its licensed indications for patients who could not tolerate low-dose aspirin and who had either had a stroke or MI or had symptomatic peripheral arterial disease.

Primary Care Cardiovascular Society spokesman Dr John Pittard said it was wrong to restrict clopidogrel to aspirin-

intolerant patients. 'It's the

institute for cost evasion.'

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