What is the evidence for the use of DAPT with aspirin and clopidogrel for short-term secondary stroke prevention?
Recommendations for the short-term (21 90 days) use of DAPT with aspirin and clopidogrel are informed by 2 major randomized controlled trials (RCTs) - the CHANCE and POINT trials - which compared DAPT with SAPT with aspirin initiated early after onset (<24 and <12 hours, respectively) of minor stroke (NIHSS score 3) or high-risk TIA (ABCD2 score 4) but varied in duration of DAPT treatment (21 and 90 days, respectively). The CHANCE and POINT trials showed that DAPT was superior to SAPT in reducing the risk of stroke or death among patients with minor stroke or high-risk TIA. A systematic review by an American Heart Association (AHA) Evidence Review Committee also concluded that DAPT with aspirin and clopidogrel is more effective than SAPT for short-term secondary stroke prevention. 