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Can the ESPRIT results end the antiplatelet battle between neurologists and cardiologists?

Nature Clinical Practice Cardiovascular Medicine volume 4, pages 118–119 (2007)Cite this article

The combination of extended-release dipyridamole and aspirin is an effective therapy for secondary stroke prevention.1 Some cardiologists avoid this combination, however, because of concern that dipyridamole might increase the risk of cardiac events in patients with coronary artery disease (CAD). A dilemma can, therefore, arise when a patient with stable CAD suffers an ischemic stroke or transient ischemic attack (TIA)—the combination of dipyridamole and aspirin is prescribed for secondary stroke prevention by a neurologist and, subsequently, the patient's cardiologist recommends that this therapy be discontinued.

Recently, the European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT)2 confirmed that the combination of dipyridamole and aspirin has a substantial beneficial effect for the prevention of vascular events in patients with a recent ischemic stroke or TIA, when compared with aspirin alone. These results, in conjunction with prior evidence from the European Stroke Prevention 2 (ESPS2) study,3 provide considerable reassurance that combination therapy with dipyridamole and aspirin is beneficial for patients with a recent history of brain ischemia, irrespective of whether they have a history of CAD.

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  1. Neurology and Neurological Sciences, Stanford University, 701 Welch Road # 325, Stanford, CA 94305, USA albers@stanford.edu

Authors and Affiliations

  1. GW Albers is Professor of Neurology and Neurological Sciences, and Director of the Stanford Stroke Center, Stanford University Medical Center, Palo Alto, CA, USA. He is also an Advisory Board member of Nature Clinical Practice Cardiovascular Medicine.,

    Gregory W Albers

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Competing interests

GW Albers has received research support from and has acted as a consultant for Boehringer Ingelheim, Bristol-Myers Squibb, and Sanofi-Synthelabo. He is also on the speaker's bureau of Boehringer Ingelheim.

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Albers, G. Can the ESPRIT results end the antiplatelet battle between neurologists and cardiologists?. Nat Rev Cardiol 4, 118–119 (2007). https://doi.org/10.1038/ncpcardio0803

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