Profess trial results

There were no significant differences in the proportion of patients with cognitive impairment or dementia among the treatment groups. This substudy concluded that disability due to recurrent stroke and cognitive decline were not different between the two antiplatelet regimens and were not affected by the preventive use of telmisartan.

Trials of clopidogrel plus aspirin showed a greater risk of life-threatening bleeding as compared with monotherapy; however, earlier trials of ASA-ERDP showed no increased risk of life-threatening bleeding as compared with aspirin alone.

The conclusion of the trial was that net risk of recurrent stroke or major hemorrhagic event was similar with the two antiplatelet agents and that there was no evidence that either of the two treatments was superior to the other in the prevention of recurrent stroke. The results of PRoFESS indicate that we have a choice of antiplatelet agents of overlapping efficacy; other factors in the choice include cost and tolerability. In the next few years we may have even more choices if prasugrel, a new thienopyridine with greater antiplatelet potency but more hemorrhagic risk, becomes available for recurrent ischemic stroke risk reduction.

The editorial by Kent and Thaler accompanying the New England Journal of Medicine publication used a zen approach to interpret the results, concluding "For stroke prevention, use an antiplatelet drug. Treat hypertension. Antiplatelet treatment must be accompanied by aggressive life style adjustment and management of medical risk factors, especially hypertension.

In addition, by the time recurrent ischemic stroke risk reduction is considered, the patient may already have permanent neurological disability. We need better implementation of the lifestyles and medical treatments that we know will prevent the first ischemic stroke. Then we can effectively prevent ischemic stroke recurrence. Reprints Share. Raffaele Milano, Italy 9. Luca" Milano, Italy 9. Carlo Borromeo" Milano, Italy 9.

Maria di Loreto Mare" Napoli, Italy 9. Andrea Roma, Italy 9. Giovanni Battista" Torino, Italy 9. Jazzolino Vibo Valentia, Italy 9. Jans Gasthuis Weert, Netherlands Norway 9. Petersburg, Russian Federation 9.

Izmir, Turkey Ukraine 9. More Information. Additional Information: Related Info. Related Info. Low glomerular filtration rate, recurrent stroke risk, and effect of renin-angiotensin system modulation.

Epub Aug Impact of resting heart rate on mortality, disability and cognitive decline in patients after ischaemic stroke. Eur Heart J. Telmisartan on top of antihypertensive treatment does not prevent progression of cerebral white matter lesions in the prevention regimen for effectively avoiding second strokes PRoFESS MRI substudy. Epub Jun Epub Jan Level of systolic blood pressure within the normal range and risk of recurrent stroke.

Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes PRoFESS trial: a double-blind, active and placebo-controlled study. Lancet Neurol. Erratum in: Lancet Neurol. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke.

ClotCare complies with the HONcode standard for trustworthy health information: verify here. Susan C. Fagan, Pharm. Although the results of noncomparative clinical trials led experts in the stroke field to prefer the combination of aspirin and extended release dipyridamole ERDP over clopidogrel or aspirin for secondary prevention of noncardioembolic stroke, all three agents were first line in recent guidelines.

ProFESS was the largest stroke trial ever performed with more than 20, patients enrolled in 35 different countries. Even in the ARB arm, where prior publications suggested that ARBs would provide vascular protection, there was no difference.