Mark J. Alberts, MD


February 14, 2012

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Hello. I'm Dr. Mark Alberts, Head of the Stroke Program at Northwestern University in Chicago. Welcome to this Medscape stroke update. Today, I would like to describe the results of the SPS3 study,[1] which were presented at the International Stroke Conference (ISC) in New Orleans in February 2012.

The long-running study results were announced after the study was stopped early by the Data and Safety Monitoring Board (DSMB). SPS3 was a prospective, randomized trial of patients with small subcortical strokes who were randomly assigned to receive combination antiplatelet therapy -- aspirin plus clopidogrel -- or aspirin alone. The DSMB stopped the study early for 2 reasons. First, there was evidence of more bleeding in the group that received aspirin plus clopidogrel compared with aspirin alone. Second, based on the futility analysis, there was no evidence that the combination antiplatelet group did any better than the monotherapy group in terms of preventing subsequent stroke, myocardial infarction, or vascular death.

Another part of the SPS3 study is still ongoing, and that is intensive blood pressure lowering vs standard blood pressure lowering to ascertain whether that has any impact on vascular events and dementia. The results of that part of the study will not be known until perhaps later in the year.

Now we have the results of a part of SPS3, which show that in people with small-vessel subcortical strokes, monotherapy with aspirin appears to be safer and as effective as combination therapy with aspirin plus clopidogrel. In that regard, SPS3 mirrors what was found in the MATCH study several years ago.

This was a quick update about another study presented at the ISC in New Orleans. Thank you very much.


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