has your patient had carotid dopplers done?
Recent study in the lancet www.thelancet.com of clopidogrel vs asprin
Lancet 2004; 364: 331-37
24 July 2004
shows no benefit of adding asprin to clopidogrel - increase in AE's of
haemorrhage. clopidogrel is very marginally better than asprin alone
(caprie study), NNT about 100. cost of clopidogrel is ridiculous.
Also look at a wonderful pharmacoeconomic study done by Hankey
Treatment and secondary prevention of stroke: evidence, costs, and
effects on individuals and populations
Graeme J Hankey, Charles P Warlow
Volume 354 Issue 9188 Page 1457
Rgds
leon
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Paul Bromley
> Sent: 18 August 2004 10:04 PM
> To: [log in to unmask]
> Subject: Aspirin/Clopidogrel/Dipyridamole in patinet with CVA
> taking Aspirin.
>
>
> Can someone remind me about this one or point me in the right
> direction. 65 year old with IHD + Hypertension and already on
> Aspirin - labelled as TIA last week by one of our locums but
> still with deficit this week (dysarthria and some diplopia).
> Awaiting MR scan. Should I be adding or substituting
> Clopidogrel or Dipyridamole at this point or awaiting MR scan
> result before doing anything? With MR scan result if embolic,
> should I be adding/substituting? BP management OK and already
> on a Statin.
>
> Best wishes
>
> Paul Bromley
>
> ---
> Incoming mail is certified Virus Free.
> Checked by AVG anti-virus system (http://www.grisoft.com).
> Version: 6.0.726 / Virus Database: 481 - Release Date: 2004/07/22
>
>
---
Outgoing mail is certified Virus Free.
Checked by AVG anti-virus system (http://www.grisoft.com).
Version: 6.0.726 / Virus Database: 481 - Release Date: 2004/07/22
|