Clopidogrel and Aspirin versus Aspirin Alone for the Treatment of High-risk

Patients with Acute Non-disabling Cerebrovascular Event (CHANCE): A

Randomized, Double-blind, Placebo-controlled Multicenter Trial
Background: Acute cerebrovascular events such as transient ischemic
attack (TIA) and minor stroke are common and the subsequent stroke risk
is very high. The optimum treatment options for patients of acute
cerebrovascular events are not known. There has been no large-scale
evaluation on the combined use of clopidogrel and aspirin as an acute
intervention in these patients.

Results:

Objectives: Reduction of 3-month risk of new stroke (ischemic or

hemorrhagic) in patients with high-risk TIA or minor stroke comparison
of 3-months of clopidogrel-aspirin (300 mg load followed by 75 mg/day)
vs. aspirin alone and started within 24 hours of symptom onset.
Methods: n=5170; double-blind, multicenter, placebo-controlled.
Randomized to 1) 90-days of clopidogrel (loading dose of 300 mg
followed by 75 mg/d) + aspirin 75 mg/d during the first 21 days; or 2) 90days of aspirin 75 mg/d alone.
Primary endpoints: Efficacy: any recurrent stroke (ischemic or
hemorrhagic) at 90 days. Safety : combined moderate and severe
bleeding.
Conclusions: In high-risk patients with a TIA or minor stroke, the 3-month
risk for further strokes is reduced with clopidogrel ( 300 mg load) +
aspirin compared to aspirin alone. Clopidogrel-aspirin did not increase in
bleeding.

Presented by: Wang Y, International Stroke Conference, Honolulu, HI

2013, American Heart Association. All rights reserved.