Introduction & Background:
Lacunar stroke, comprising 18% of Ischemic stroke, is the second most common subtype of stroke in India. Available data on the effect of dual antiplatelets treatment with aspirin plus clopidogrel vs single antiplatelet therapy with aspirin alone and their doses in Lacunar stroke happens to be very limited.  
Aim: The aim of our study was to decipher the efficacy, safety & tolerability of dual versus single antiplatelet therapy in the treatment of patients with recent occurrence of lacunar stroke.
Materials& Methods: It was a prospective, single centre study conducted at the Department of Neurology. Patients with recent occurrence of Lacunar stroke were randomly divided into 4 groups to receive Aspirin 150 mg (Group1), Aspirin 150 mg plus clopidogrel 75 mg (Group 2), aspirin 75mg plus clopidogrel 75 mg (Group 3), and aspirin 75 mg (Group 4) once daily and were closely monitored for 90 days.
Results: 360 patients were recruited and followed for 90 days. Mean age of the patients was 57.8 ±14.1 years. 188 patients (52.2%) were males. Recurrence of Ischemic stroke occurred highest in group 4 (22%) with no recurrence in group 2 .Comparisons of recurrence of Ischemic stroke between group 1 and group 4 (95% CI: 2.6829% to 31.73551%) and between group 3 and group 4 (95% CI: 3.9439% to 32.1542%) showed a statistically significant value <0.05. Haemorrhagic events occurred among recipients on dual antiplatelets therapy.
Conclusions: Efficacy wise, Group 2 with 150 mg aspirin plus 75 mg clopidogrel, was found superior to other groups in the prevention of Lacunar stroke. Groups with dual antiplatelet therapy manifested a worrisome thread of bleeding events.

     

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