Given the frequency of stroke and TIA and the devastating consequences, preventing recurrence is important for patients and their physicians.
Patients who had had a stroke or a TIA and were randomized to take ASA plus dipyridamole compared to ASA alone had increased rates of myocardial infarction, although the results were marginally not significant.
ASA in doses between 75 and 150 mg/d should remain the gold standard of treatment to prevent stroke in high-risk patients (those who have had a previous stroke or a TIA), according to Dr. Sudlow's analysis. Further, the addition of dipyridamole, as now recommended by NICE, is rarely justified, even in-patients who have suffered another stroke while taking ASA.
p. 1051 What is the role of dipyridamole in long-term secondary prevention after an ischemic stroke or transient ischemic attack?
-- C. Sudlow
http://www.cmaj.ca/misc/press/pg1024.pdf
Canadian Medical Association Journal