Article Figures & Data
Figures
- Figure 1
Comparison of dual antiplatelet versus monotherapy in acute ischaemic stroke or transient ischaemic attack on stroke recurrence. A, aspirin; C, clopidogrel; D, dipyridamole; M-H, Mantel-Haenszel method.
- Figure 2
Comparison of dual antiplatelet versus monotherapy in acute ischaemic stroke or transient ischaemic attack on composite outcome of stroke, transient ischaemic attack, acute coronary syndrome and all death. A, aspirin; C, clopidogrel; D, dipyridamole; M-H, Mantel-Haenszel method.
- Figure 3
Comparison of dual antiplatelet versus monotherapy in acute ischaemic stroke or transient ischaemic attack on major bleeding. A, aspirin; C, clopidogrel; D, dipyridamole; M-H, Mantel-Haenszel method.
- Figure 4
Comparison of the separate POINT results and the overall estimates of dual antiplatelet versus monotherapy from all other trials included in the present meta-analysis on major bleeding; M-H, Mantel-Haenszel method.
Tables
- Table 1
Design and baseline characteristics of included trials
Trial Dual therapy Monotherapy Duration for dual therapy Treatment onset Patients Severity of stroke Country Size
(<3 days)Blinding ITT analysis Lost to follow-up (%) Quality POINT
20189Clop (600 mg load, 75 mg once daily)+Asp (50–325 mg once daily) Asp 3 months ≤12 hours Minor IS, TIA NIHSS≤3 Worldwide,
269 centres4881 Double
blindITT 6.6 A COMPRESS
201622Clop (75 mg once daily without load)+Asp (300 mg load, 100 mg once daily) Asp 30 days ≤2 days IS UNK Korea, 20 centres 358 Double
blindITT 6.7 A He et al 23 Clop (300 mg load, 75 mg once daily)+Asp (100 mg once daily) Asp (300 mg once daily) 14 days ≤3 days Minor IS, TIA NIHSS ≤7 China, single centre 690 UNK Analysed as treated 6.2 A Yi et al 24 Clop (75 mg once daily)+Asp (200 mg) for 30 days, then Clop alone (75 mg once daily) Asp (200 mg once daily for 30 days, then 100 mg once daily) 30 days ≤2 days IS NIHSS ≤12 China,
two centres574 Blinded outcome Analysed as treated 0.7 A CHANCE
20126Clop (300 mg load, 75 mg once daily)+Asp (75–300 mg load, 75 mg once daily) for 21 days, then Clop alone (75 mg) Asp (75–300 mg load, 75 mg once daily) for 3 m 21 days ≤24 hours Minor IS, TIA NIHSS ≤3 China,
114 centres5170 Double
blindITT 0.7 A Nakamura et al
21Cilo (100 mg twice daily)+Asp (300 mg, then 100 mg once daily) Asp 6 months ≤2 days Minor IS NIHSS ≤7 Japan, single centre 76 UNK On-treatment analysis 16.7 B CLAIR
20104Clop (300 mg load, 75 mg once daily)+Asp (75–160 mg once daily) Asp 7 days ≤3 days Minor IS, TIA NIHSS ≤8 Asia, multicentres 98 Blinded outcome ITT 1.0 A PRoFESS
200919Dip (200 mg twice daily)+Asp (25 mg twice daily) Clop (75 mg once daily) 3 months ≤3 days IS mRS 0–3 Worldwide,
695 centres1360 Double
blindITT 0.9 A EARLY
200920Dip (200 mg twice daily)+Asp (25 mg twice daily) for 3 months Asp (100 mg once daily) for 7 days, then Dip (200 mg twice daily)+Asp (25 mg twice daily) 3 months ≤24 hours IS, TIA NIHSS ≤20 Germany,
46 centres543 Blinded outcome Analysed as treated 2.9 A FASTER
200718Clop (300 mg load, 75 mg once daily)+Asp (162 mg, then 81 mg once daily) Asp 3 months ≤24 hours Minor IS, TIA NIHSS ≤3 North America,
18 centres392 Double
blindITT 1.8 A ESPRIT
200617Dip (200 mg twice daily)+Asp (30–325 mg once daily) Asp 42 months ≤3 days Minor IS, TIA mRS ≤3 Worldwide,
86 centres95 Open ITT 3.8 A CHARISMA
200616Clop (75 mg once daily)+Asp (75–162 mg once daily) Asp 28 months ≤24 hours IS, TIA UNK Worldwide,
768 centres216 Double
blindITT ≤0.5 A Chairangsarit
et al 15Dip (225 mg once daily)+Asp (300 mg once daily) Asp 6 months ≤2 days IS UNK Thailand, single centre 38 Open UNK UNK A CARESS
20053Clop (300 mg load, 75 mg once daily)+Asp (75 mg once daily) Asp 7 days ≤3 days IS, TIA NIHSS＜22 Europe,
11 centres25 Double
blindITT 0 A MATCH
200414Clop (75 mg once daily)+Asp (75 mg once daily) Clop 18 months ≤3 days IS, TIA mRS 0–5 Worldwide,
507 centres491 Double
blindITT 4 A ESPS 2
199613Dip (200 mg twice daily)+Asp (25 mg twice daily) Asp or Dip 24 months ≤3 days IS, TIA mRS 0–5 Europe,
59 centres221 Double
blindITT 0.64 A Kaye12 Dip+Asp (900 mg once daily) Asp UNK ≤3 days IS UNK UNK 178 UNK UNK UNK B Matías-Guiu et al
11Dip (100 mg four times daily)+Asp (50 mg once daily) Dip 21.4 ≤3 days TIA UNK Spain, single centre 109 Open UNK 4.5 B Quality scale: A, true randomisation and allocation concealed; B, process of randomisation not given and concealment of allocation unclear.
Asp, aspirin; Cilo, cilostazol; Clop, clopidogrel; Dip, dipyridamole; IS, ischaemic stroke; ITT intention to treat; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; TIA, transient ischaemic attack; UNK, unknown.
Supplementary file 1
Supplementary file 2
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