Dell Medical School study helping prevent future strokes by combining drugs

Good news out of the University of Texas Dell Medical School:

A new treatment of combining two drugs after having a mini stroke or transient ischemic stroke has been shown to lower the risk of having a major stroke, heart attack or death by 25 percent in the next 90 days. The international study of 4,881 adults in 10 countries was published in The New England Journal of Medicine.  Dr. Clay Johnston, dean and professor of neurology at Dell Medical School was the lead author.

The study combined clopidogrel also known as Plavix and aspirin. The study compared using the combination drug and using just aspirin.

RAPID CT perfusion scan allows doctors to see what area of the brain and how much it is being affected by a stroke.

In a press release Johnson said, “The study gives us solid evidence that we can use this drug combination to prevent strokes in the highest-risk people, but not without some risk of bleeding.”

The study did show that for every 1,000 patients, there were five extra major bleeds but 15 fewer strokes or other “major ischemic events” within that 90 day period. Because the bleeding events are generally reversible, the overall benefit outweighs the risk for most patients, Johnston said in that press release. More than half of the 33 major hemorrhages that occurred were in the gastrointestinal track. No one died because of the bleeding, and the bleeds were thought to be preventable and treatable, and worth the risk.

Having a minor stroke or a TIA means that a person has a 3 percent to 15 percent chance of having a more severe stroke in the next three months, typically. The American Stroke Association estimates that more than a third of U.S. adults have had TIA symptoms.

“It’s likely we will see more patients who have had a TIA or a minor stroke receiving the combination of clopidogrel and aspirin in the future,” Johnston said in a press release. “If you’ve suffered from a minor stroke or TIA, it’s important to see a physician immediately, even in the emergency room, to ensure you’re taking steps to avoid a potentially debilitating stroke later on,” he said. “There are several tests that need to be done right away to determine the cause of the event and to make sure the best treatments are started as soon as possible.”

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