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(Stroke. 2006;37:2856.)
© 2006 American Heart Association, Inc.

Emerging Therapies

How Much Esprit Is in ESPRIT?

From the Department of Neurology, University Duisburg-Essen, Essen, Germany.

Correspondence to H.C. Diener, MD, Department of Neurology, University Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. E-mail h.diener@uni-essen.de

Section Editors: Marc Fisher MD Kennedy Lees MD

Key Words: aspirin • dipyridamole • secondary prevention • stroke • transient ischemic attack

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Stroke is the leading cause of disability in industrialized countries and poses an increasing burden on public and private healthcare systems. Owing to increasing life expectancy, the rate of first stroke is expected to continue to rise.¹ In contrast, the rate of recurrent stroke is more susceptible to medical prevention strategies and therefore could be effectively reduced. In addition to control of the classic cardiovascular risk factors, both oral anticoagulants (vitamin K antagonists) and platelet inhibitors have been shown to decrease the relative risk of stroke recurrence by 13% to 67%.² Several antiplatelet drugs have been investigated for the secondary prevention of stroke, including aspirin, ticlopidine, clopidogrel, and dipyridamole (DP). In addition, the combination of DP plus aspirin has been compared versus aspirin and the combination of clopidogrel plus aspirin versus aspirin³ or clopidogrel.⁴

In the following section, I will review the results from clinical trials investigating the benefit and risk of the combination of aspirin and DP versus placebo and aspirin monotherapy. In addition, I will compare the study design and results of t European Stroke Prevention Study 2 (ESPS2)⁵ and the recently published European/Australian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT) study.⁶

Early studies investigating the combination of DP plus aspirin versus aspirin monotherapy failed.^7–9 Those trials used a rapid-release form of DP and were apparently underpowered in terms of sample size.

ESPS2 was a randomized, double-blind, placebo-controlled trial that compared aspirin alone (50 mg daily), modified-release DP alone (200 mg twice daily), aspirin plus DP, and placebo . . . [Full Text of this Article]

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