Which anti-platelet drug is most effective for preventing stroke?

This study looked at the use of antiplatelet medications to prevent stroke. They found that patients taking aspirin or ticlopidine (Ticlid) were less likely to have a second stroke than patients taking clopidogrel (Plavix).

The most common type of stroke is called an ischaemic stroke. Ischaemic stroke means that the blood supply to part of the brain has been interrupted, causing long-term damage. This type of stroke is usually caused by a blood clot which blocks a blood vessel. Patients who have had an ischaemic stroke are often started on a medication to stop the blood from clotting together. 

One type of medication that reduces blood clotting is antiplatelet medication. There are different types of antiplatelet agents. Examples include aspirin, ticlopidine, and clopidogrel. It is not clear which of these is drugs are most effective at preventing strokes.

This study involved 2,585 patients who have had an ischaemic stroke between 2000 and 2010. Patients were categorized into three groups based on which antiplatelet agent they took after the stroke: aspirin, ticlopidine, or clopidogrel. 2,068 patients used aspirin, 203 patients used ticlopidine and 314 patients used clopidogrel. Patients were followed for 3 years.

During the follow-up period, 2.03% of patients using aspirin had a stroke. Of the patients taking ticlopidine, 1.48% had a stroke and of those taking clopidogrel, 2.55% had a stroke. Patients in the clopidogrel group were 2.27 times more likely to have a second stroke than those taking aspirin. Ticlopidine and aspirin were similarly effective in preventing stroke,

This study showed that clopidogrel alone was less effective at preventing stroke than aspirin or ticlopidine in a population in Taiwan.  

This study is based on medical records, more studies are needed to confirm these findings. This study also uses a population in Taiwan. More studies are needed to see if these findings apply to other ethnicities.