According to research presented at the American Stroke Association’s International Stroke Conference, the additional of clopidogrel to aspirin to prevent recurrent strokes in patients with subcortical stroke, is unlikely to do so, and in fact may increase the risk of bleeding and death.

The Secondary Prevention of Small Subcortical Strokes Trial (SPS3)  involved 3,020 patients who were randomised to receive aspirin and clopidogrel or aspirin plus placebo daily. Preliminary findings showed that the risk of bleeding nearly doubled among patients on the clopidogrel/aspirin combination, compared to those on aspirin and placebo: Aspirin plus placebo had a 1.1% bleeding risk per year and aspirin plus clopidogrel a 2.1% bleeding risk per year. Similarly, the annual risk of death was 2.1% for patients on aspirin with clopidogrel, and 1.4% for patients on aspirin alone. There was no difference in stroke recurrence in both treatment arms.

Detailed statistical data were not available in this abstract.