In patients with previous stroke or at high vascular risk, is aspirin better than clopidogrel or ticlopidine for preventing recurrent stroke?

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Evidence-Based Answer

Aspirin is probably less expensive, but not more effective than clopidogrel or ticlopidine. Thienopyridines (ticlopidine or clopidogrel) and aspirin are equally effective in preventing recurrent strokes of all types, while thienopyridines are better for preventing recurrent ischemic strokes (SOR: A, systematic review of RCTs and single retrospective cohort study). Clopidogrel is associated with less mortality than aspirin in patients with a prior stroke (SOR: B, retrospective cohort study).

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