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(Stroke. 2009;40:1932.)
© 2009 American Heart Association, Inc.

Emerging Therapies

Digestion of the Antiplatelets Comparison of PRoFESS

18–7=1?

From the Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Correspondence to Ale Algra, MD, mailbox STR 6.131, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. E-mail a.algra@umcutrecht.nl.

Marc Fisher MD Kennedy Lees MD Section Editors

Key Words: antiplatelet agents • clinical trials • PRoFESS

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

	Introduction

 
Recently, the results of the Prevention Regimen for EFfectively avoiding Second Strokes trial (PRoFESS) were published after they had been presented at the European Stroke Conference in Nice, May 2008.¹ It was a large multicenter clinical trial among over 20 000 patients with a recent (mainly <3 months) ischemic stroke that was of noncardioembolic origin in virtually all. The trial had 2 treatment contrasts that were studied simultaneously, one on 2 antiplatelet regimens, the other on telmisartan versus placebo.² This comment addresses only the comparison of aspirin (25 mg) plus extended-release dipyridamole (200 mg) twice daily (ASA-ERDP) versus clopidogrel (75 mg) once daily. Primary outcome was recurrent stroke and secondary outcome the AntiPlatelet Trialists’ composite of vascular death, nonfatal myocardial infarction, or nonfatal stroke. Mean follow-up was 2.5 years. There were 916 recurrent strokes (primary outcome) with ASA-ERDP versus 898 with clopidogrel with a resulting hazard ratio (HR) of 1.01 (95% CI, 0.92 to 1.11). In both groups, there were 1333 vascular events (stroke, myocardial infarction, or vascular death); the HR was 0.99 (95% CI, 0.92 to 1.07) and the corresponding relative risk reduction (RRR) 1% (95% CI, –7% to 8%). In the ASA-ERDP group, there were more major hemorrhages (419) than in the clopidogrel group (365; HR, 1.15; 95% CI, 1.00 to 1.32). There was an excess of 44 intracranial hemorrhages with ASA-ERDP (147) as compared with clopidogrel (103; HR, 1.42; 95% CI, 1.11 to 1.83). For the tertiary outcome "stroke or major hemorrhage," the HR was 1.03 (95% . . . [Full Text of this Article]