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Dual antiplatelet treatment up to 72 Hours after ischemic stroke


Gao Y, Chen W, Pan Y, Jing J, Wang C, Johnston SC et al, for the INSPIRES investigators

N Engl J Med 2023; 389:2413-2424.

Some 6100 patients were included; most were randomized over 24h after the new event. A new stroke within 90 days occurred in 7.3 percent of the dual antiplatelet group compared with 9.2 per cent of those given aspirin alone (hazard ratio 0.79, 95 per cent confidence interval 0.66 to 0.94; P=0.008).

Comment: Although small increase in risk of bleeding, a conclusive result due to the large number of participants, and contemporary data.

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