What is the comparative benefit of aspirin and clopidogrel compared to warfarin for stroke prevention in patients with aortic plaque?
The only randomized trial of this condition, the ARCH study, compared aspirin and clopidogrel with warfarin and was underpowered for the primary end point. Thus, the comparative benefit of these 2 treatments is unknown. However, there were 6 vascular deaths (3.4%) in the warfarin arm and none in the dual antiplatelet arm (log-rank test, P=0.013), suggesting no advantage of warfarin over dual antiplatelets.