Media Articles Related to Aggrenox (Aspirin / Dipyridamole)
Three New Trials in Stroke: CADISS, VISSIT, and ATTEST
Source: Medscape Emergency Medicine Headlines [2015.07.21]
Dr Diener reviews three recently published trials with new findings for dissection in intracranial stenosis and thrombolysis in acute ischemic stroke.
Published Studies Related to Aggrenox (Aspirin / Dipyridamole)
Use of aspirin associates with longer primary patency of hemodialysis grafts. [2011.04]
Extended-release dipyridamole plus low-dose aspirin (ERDP/ASA) prolongs primary unassisted graft patency of newly created hemodialysis arteriovenous grafts, but the individual contributions of each component are unknown. Here, we analyzed whether use of aspirin at baseline associated with primary unassisted graft patency among participants in a randomized trial that compared ERDP/ASA and placebo in newly created grafts.
Effects of Aggrenox and aspirin on plasma endothelial nitric oxide synthase and oxidised low-density lipoproteins in patients after ischaemic stroke. The AGgrenox versus aspirin therapy evaluation (AGATE) biomarker substudy. [2011.01]
Plasma endothelial nitric oxide synthase (eNOS), and oxidised low-density lipoproteins (oxLDL) are established biomarkers of atherosclerosis... In the small randomised study, both aspirin and Aggrenox produced fast and sustained recovery of plasma eNOS levels, while only therapy with Aggrenox was associated with oxLDL inhibition late in the trial.
The Japanese aggrenox (extended-release dipyridamole plus aspirin) stroke prevention versus aspirin programme (JASAP) study: a randomized, double-blind, controlled trial. 
BACKGROUND: Despite improvements in treatment, stroke still carries a high death toll and disability in Asia. Extended-release dipyridamole (ER-DP) plus acetylsalicylic acid (ASA) has consistently been shown to be superior over conventional platelet inhibition by ASA. ER-DP plus ASA is well established in the secondary prevention of stroke in a lot of countries including the USA and Europe. DP has an established benefit in the treatment of heart disease in Japan; however, for the prevention of stroke, the fixed-dose combination of ER-DP plus ASA has only been investigated in a small number of patients in Japan... CONCLUSIONS: The results of the study are inconclusive. Noninferiority of ER-DP plus ASA versus ASA could not be established, a difference between treatments could not be shown for the primary end point. Possible reasons for this result include a small sample size, low event rates and too short a treatment duration (ClinicalTrials. gov number, NCT00311402). Copyright (c) 2011 S. Karger AG, Basel.
Safety of fixed-dose aspirin-extended-release dipyridamole in patients with ischemic heart disease. [2010.05.01]
CONCLUSION: A literature review revealed that fixed-dose aspirin-ER dipyridamole was not associated with an increased risk of cardiovascular events in patients with ischemic heart disease. However, individual patient factors merit consideration when choosing an antiplatelet agent for stroke prevention.
Early treatment with aspirin plus extended-release dipyridamole for transient ischaemic attack or ischaemic stroke within 24 h of symptom onset (EARLY trial): a randomised, open-label, blinded-endpoint trial. [2010.02]
BACKGROUND: Little is known about the best antiplatelet treatment immediately after ischaemic stroke or transient ischaemic attack (TIA). The EARLY trial aimed to compare outcome in patients given aspirin plus extended-release dipyridamole twice daily either within 24 h of stroke or TIA or after 7 days of aspirin monotherapy... INTERPRETATION: Early initiation of aspirin plus extended-release dipyridamole within 24 h of stroke onset is likely to be as safe and effective in preventing disability as is later initiation after 7 days. FUNDING: Boehringer Ingelheim. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Clinical Trials Related to Aggrenox (Aspirin / Dipyridamole)
JASAP: Japanese Aggrenox Stroke Prevention vs. Aspirin Programme [Active, not recruiting]
Phase III study to compare the preventive effect of recurrent brain infarction and safety of
Aggrenox (combination drug containing sustained-release dipyridamole 200 mg/acetylsalicylic
acid 25 mg) twice daily vs. acetylsalicylic acid 81 mg once daily
Headache Study to Compare Aggrenox Full Dose and Reduced Dose [Completed]
Tolerability of a four weeks treatment with Aggrenox« modified release capsules b. i.d,
compared to reduced dose during the first two weeks of treatment in a double-blind,
randomized controlled parallel group comparison trial among Taiwanese patients with previous
TIA's or ischemic stroke. To monitor frequency and intensity of headaches and other safety
parameters among Taiwanese patients with previous TIA's or ischemic stroke given Aggrenox
using a titration scheme or not
EARLY 3-Months Aggrenox Treatment Started Within 24 Hrs of Ischemic Stroke Onset vs. After One Week 100 mg ASA [Recruiting]
German stroke units are hesitating to use Aggrenox for secondary ischaemic stroke / transient
ischaemic attack (TIA) prevention in a sub-acute treatment setting. They argue that clinical
experience with sub-acute Aggrenox treatment is limited and poorly documented when compared
with sub-acute acetylsalicylic acid (ASA) treatment. However, long term treatment (started
after 3-6 months after stroke/TIA) with Aggrenox was safe and superior to ASA treatment in
preventing recurrent strokes. There is no evidence for ASA to prevent from neurological
progression after stroke during the first 3 months. Results from a cohort study suggest that
starting Aggrenox within 72 hours after stroke predicts clinical improvement in the NIHSS at
discharge from the hospital. Dipyridamole suppresses acute inflammatory responses to stroke.
This study is designed to investigate the tolerability and efficacy of a secondary stroke
prevention treatment with Aggrenox when initiated within 24 hours of stroke onset on a stroke
unit compared to later initiation after a 7 day ASA treatment and outside off a stroke unit
Vascular Access Clinical Trials Data Coordinating Center [Completed]
Fistula Study: The objective of the study is to determine whether clopidogrel reduces the
early failure rate of native AV fistulae.
Graft Study: The objective of the study is to determine whether Aggrenox
(Boehringer-Ingelheim) prolongs primary unassisted patency in newly created arteriovenous
Treatment of Supine Hypertension in Autonomic Failure [Recruiting]
Supine hypertension is a common problem that affects at least 50% of patients with primary
autonomic failure. Supine hypertension can be severe, and complicates the treatment of
orthostatic hypotension. Drugs used for the treatment of orthostatic hypotension (eg,
fludrocortisone and pressor agents), worsen supine hypertension. High blood pressure may
also cause target organ damage in this group of patients. The pathophysiologic mechanisms
causing supine hypertension in patients with autonomic failure have not been defined.
In a study, we, the investigators at Vanderbilt University, examined 64 patients with AF, 29
with pure autonomic failure (PAF) and 35 with multiple system atrophy (MSA). 66% of patients
had supine systolic (systolic blood pressure [SBP] > 150 mmHg) or diastolic (diastolic blood
pressure [DBP] > 90 mmHg) hypertension (average blood pressure [BP]: 179 ┬▒ 5/89 ┬▒ 3 mmHg in
21 PAF and 175 ┬▒ 5/92 ┬▒ 3 mmHg in 21 MSA patients). Plasma norepinephrine (92 ┬▒ 15 pg/mL)
and plasma renin activity (0. 3 ┬▒ 0. 05 ng/mL per hour) were very low in a subset of patients
with AF and supine hypertension. (Shannon et al., 1997).
Our group has showed that a residual sympathetic function contributes to supine hypertension
in patients with severe autonomic failure and that this effect is more prominent in patients
with MSA than in those with PAF (Shannon et al., 2000). MSA patients had a marked depressor
response to low infusion rates of trimethaphan, a ganglionic blocker; the response in PAF
patients was more variable. At 1 mg/min, trimethaphan decreased supine SBP by 67 +/- 8 and
12 +/- 6 mmHg in MSA and PAF patients, respectively (P < 0. 0001). MSA patients with supine
hypertension also had greater SBP response to oral yohimbine, a central alpha2 receptor
blocker, than PAF patients. Plasma norepinephrine decreased in both groups, but heart rate
did not change in either group. This result suggests that residual sympathetic activity
drives supine hypertension in MSA; in contrast, supine hypertension in PAF.
It is hoped that from this study will emerge a complete picture of the supine hypertension
of autonomic failure. Understanding the mechanism of this paradoxical hypertension in the
setting of profound loss of sympathetic function will improve our approach to the treatment
of hypertension in autonomic failure, and it could also contribute to our understanding of
hypertension in general.
Reports of Suspected Aggrenox (Aspirin / Dipyridamole) Side Effects
Cerebral Haemorrhage (11),
Loss of Consciousness (11),
Decreased Appetite (11),
Gastrooesophageal Reflux Disease (9),
Dementia (8), more >>