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At the heart of general practice since 1960

Stroke drug is backed

By Emma Wilkinson

GPs have been urged to prescribe aspirin and dipyridamole for secondary prevention of stroke after new research found the combination was better than aspirin alone.

An international trial found dipyridamole and aspirin reduced risk of the primary endpoint ­ a composite of vascular events and deaths ­ by 20 per cent compared with aspirin alone.

Patients on the combination had an absolute risk reduction of 1 per cent a year of death from any vascular cause, non-

fatal stroke, non-fatal myocardial infarction or a major bleeding complication.

Data from the trial, published in The Lancet this week, was added to a new meta-analysis which found the combination reduced vascular death, stroke or heart attack by 18 per cent compared with aspirin alone.

Study leader Professor Ale Algra, professor of clinical epidemiology at the Julius Center for Health Sciences and Primary Care in Utrecht, the Netherlands, said: 'The results provide sufficient evidence to prefer combination therapy of aspirin and dipyridamole over aspirin monotherapy.'

The trial of 2,700 patients who had suffered an ischaemic stroke of presumed arterial origin reported primary events in 13 per cent of patients on combination therapy and 16 per cent with aspirin alone.

But patients on the combination treatment were more likely to stop their medication because of side-effects such as headache.

UK experts said cost might put GPs off prescribing dipyridamole, even with previous evidence suggesting it was cost-

effective.

pulse@cmpi.biz

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