Dual Antiplatelet Therapy Versus Aspirin in Patients With Stroke or Transient Ischemic Attack

Meta-Analysis of Randomized Controlled Trials

Kirtipal Bhatia, MD; Vardhmaan Jain, MD; Devika Aggarwal, MD; Muthiah Vaduganathan, MD, MPH; Sameer Arora, MD, MPH; Zeeshan Hussain, MD; Guneesh Uberoi, MD; Alfonso Tafur, MD, MSc; Cen Zhang, MD; Mark Ricciardi, MD; Arman Qamar, MD, MPH


Stroke. 2021;52(6):e217-e223. 

In This Article


DAPT with aspirin and ticagrelor or clopidogrel given within 24 hours of high-risk TIA or noncardioembolic mild to moderate stroke effectively reduces the risk of recurrent stroke and MACE compared with aspirin monotherapy. DAPT is associated with a higher risk of bleeding events, but there is no difference in the risk of all-cause death. Thus, the decision to use DAPT with the addition of clopidogrel or ticagrelor to aspirin must be individualized and guided by the patient's underlying thrombotic and bleeding risk profile.