The findings suggest that for 1,000 patients, clopidogrel plus aspirin would prevent 15 ischemic attacks, but may cause five instances of major hemorrhage. The majority of these hemorrhages occurred outside of the brain and were not fatal.
“We saw a real benefit with the combination therapy, but that treatment does come with a risk,” said Dr. Johnston. “Overall, the risk of severe bleeding was very small, but it was not zero.”
The study was stopped early because the combination therapy was found to be more effective than aspirin alone in preventing severe strokes, but also due to the risk of severe hemorrhage.
Clopidogrel and aspirin prevent platelets from sticking together and forming clots in blood vessels, although they work in different ways. Aspirin blocks molecules that activate the clotting process, while clopidogrel prevents a specific chemical from attaching to a receptor.
“Each year, strokes cause millions of disabilities around the world, and preventing many of those would lead to not only tremendous health savings, but also to improved quality of life for many individuals and their families,” said Dr. Johnston.
POINT was supported by NINDS’s Neurological Emergencies Treatment Trials (NETT) Network, a system of research institutions dedicated to emergency issues such as stroke.
More research is needed to investigate ways to lower the risk of bleeding and examine the impact of treatment timing on outcomes. In addition, future studies may help identify similar drugs that are associated with fewer adverse events.