The Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial demonstrated that the addition of clopidogrel to low-dose ASA in Chinese patients with acute minor stroke or transient ischemic attack provided better protection against subsequent stroke compared to ASA alone (Wang et al. N Engl J Med 2013;369:11-19).

Subjects in that study (n=5,170) were randomized within 24 hours of minor ischemic stroke/high-risk TIA to ASA 75 mg/day x 90 days, or ASA 75 mg/day x 21 days + clopidogrel at a loading dose of 300 mg, followed by 75 mg/day x 90 days. All subjects received ASA at a dose determined by the clinician (75-300 mg) on day 1. The rate of subsequent stroke at 90 days was 8.2% in the ASA-clopidogrel group versus 11.7% in the ASA alone group (hazard ratio 0.68). The rate of moderate/severe hemorrhage (0.3%) and hemorrhagic stroke (0.3%) were the same with the two regimens. Read More