Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/12159
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dc.contributor.authorAmarenco, Pierreen
dc.contributor.authorDavis, Stephen Men
dc.contributor.authorJones, Elizabeth Fen
dc.contributor.authorCohen, Ariel Aen
dc.contributor.authorHeiss, Wolf-Dieteren
dc.contributor.authorKaste, Markkuen
dc.contributor.authorLaouénan, Cédricen
dc.contributor.authorYoung, Dennisen
dc.contributor.authorMacleod, Malcolm Ren
dc.contributor.authorDonnan, Geoffrey Aen
dc.date.accessioned2015-05-16T01:48:37Z
dc.date.available2015-05-16T01:48:37Z
dc.date.issued2014-04-03en
dc.identifier.citationStroke; A Journal of Cerebral Circulation 2014; 45(5): 1248-57en
dc.identifier.govdoc24699050en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/12159en
dc.description.abstractSevere atherosclerosis in the aortic arch is associated with a high risk of recurrent vascular events, but the optimal antithrombotic strategy is unclear.This prospective randomized controlled, open-labeled trial, with blinded end point evaluation (PROBE design) tested superiority of aspirin 75 to 150 mg/d plus clopidogrel 75 mg/d (A+C) over warfarin therapy (international normalized ratio 2-3) in patients with ischemic stroke, transient ischemic attack, or peripheral embolism with plaque in the thoracic aorta>4 mm and no other identified embolic source. The primary end point included cerebral infarction, myocardial infarction, peripheral embolism, vascular death, or intracranial hemorrhage. Follow-up visits occurred at 1 month and then every 4 months post randomization.The trial was stopped after 349 patients were randomized during a period of 8 years and 3 months. After a median follow-up of 3.4 years, the primary end point occurred in 7.6% (13/172) and 11.3% (20/177) of patients on A+C and on warfarin, respectively (log-rank, P=0.2). The adjusted hazard ratio was 0.76 (95% confidence interval, 0.36-1.61; P=0.5). Major hemorrhages including intracranial hemorrhages occurred in 4 and 6 patients in the A+C and warfarin groups, respectively. Vascular deaths occurred in 0 patients in A+C arm compared with 6 (3.4%) patients in the warfarin arm (log-rank, P=0.013). Time in therapeutic range (67% of the time for international normalized ratio 2-3) analysis by tertiles showed no significant differences across groups.Because of lack of power, this trial was inconclusive and results should be taken as hypothesis generating.http://www.clinicaltrials.gov. Unique identifier: NCT00235248.en
dc.language.isoenen
dc.subject.otheraortaen
dc.subject.otheratherosclerosisen
dc.subject.othercerebral infarctionen
dc.subject.otherAgeden
dc.subject.otherAged, 80 and overen
dc.subject.otherAnticoagulants.administration & dosage.pharmacologyen
dc.subject.otherAorta, Thoracic.pathologyen
dc.subject.otherAortic Diseases.drug therapy.epidemiology.mortalityen
dc.subject.otherAspirin.administration & dosage.pharmacologyen
dc.subject.otherBrain Ischemia.drug therapy.epidemiology.mortalityen
dc.subject.otherDrug Therapy, Combinationen
dc.subject.otherEmbolism.drug therapy.epidemiology.mortalityen
dc.subject.otherFemaleen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherPlaque, Atherosclerotic.drug therapy.epidemiology.mortalityen
dc.subject.otherPlatelet Aggregation Inhibitors.administration & dosage.pharmacologyen
dc.subject.otherProspective Studiesen
dc.subject.otherSingle-Blind Methoden
dc.subject.otherStroke.drug therapy.epidemiology.mortalityen
dc.subject.otherTiclopidine.administration & dosage.analogs & derivatives.pharmacologyen
dc.subject.otherTreatment Outcomeen
dc.subject.otherWarfarin.administration & dosage.pharmacologyen
dc.titleClopidogrel plus aspirin versus warfarin in patients with stroke and aortic arch plaques.en
dc.typeJournal Articleen
dc.identifier.journaltitleStrokeen
dc.identifier.affiliationDepartment of Cardiology, Austin Health, Heidelberg, Victoria, Australia (E.F.J.); Max Planck Institute for Neurological Research, Cologne, Germany (W.-D.H.); Department of Neurology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland (M.K.); Stroke and Ageing Research Centre, Monash University, Melbourne, Australia (D.Y.); and Division of Clinical Neurosciences, University of Edinburgh (SC005336), Scotland, United Kingdom (M.M.).en
dc.identifier.affiliationDepartment of Neurology, Royal Melbourne Hospital (S.D.) and Florey Institute of Neuroscience and Mental Health (D.Y., M.M., G.A.D.), University of Melbourne, Melbourne, Australiaen
dc.identifier.affiliationFrom the Department of Neurology, Stroke Centre, DHU FIRE, INSERM U 1148, Paris Diderot-Sorbonne University, Hôpital Bichat (P.A.), Department of Cardiology, Saint-Antoine Hospital and Medical School, Univeristé Pierre et Marie Curie (A.A.C.), and Department of Biostatistics, Paris-Diderot-Sorbonne University, Hôpital Bichat (C.L.), Assistance Publique-Hôpitaux de Paris, Paris, Franceen
dc.identifier.doi10.1161/STROKEAHA.113.004251en
dc.description.pages1248-57en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/24699050en
dc.contributor.corpauthorAortic Arch Related Cerebral Hazard Trial Investigatorsen
dc.type.austinJournal Articleen
local.name.researcherDonnan, Geoffrey A
item.languageiso639-1en-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
crisitem.author.deptCardiology-
crisitem.author.deptThe Florey Institute of Neuroscience and Mental Health-
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