6/28/23, 10:01 PM ESPRIT Pathway Feedback Search Clinical Topics Home Studies ESPRIT ESPRIT Disease Disease Acute ischemic stroke Transient ischemic attack Trial question Is combination of aspirin and dipyridamole superior to aspirin in patients with a recent history of TIA or minor stroke of presumed arterial origin? Study design Multi-center Open label RCT Population Characteristics of study participants 34.3% female N = 2763 65.7% male 2763 patients (950 female, 1789 male) Inclusion criteria: patients within 6 months of a TIA or minor ischemic stroke of presumed arterial origin Key exclusion criteria: possible cardiac source of embolism, any blood coagulation disorder, any contraindication for aspirin or dipyridamole, and a limited life expectancy Interventions N=1363 aspirin and dipyridamole (aspirin dose of 30-325 mg/day and dipyridamole dose of 400 mg daily) N=1376 aspirin alone (at a dose of 30-325 mg/day) Primary outcome Death from all vascular causes, nonfatal stroke, nonfatal myocardial infarction, or major bleeding 16.0 % 16 https://web.pathway.md/studies/recM11rZK4cqmMcZT 1/2 6/28/23, 10:01 PM ESPRIT Pathway 13 12.0 % 8.0 % 4.0 % Borderline significant decrease 0.0 % Aspirin and dipyridamole Aspirin alone Borderline significant decrease in death from all vascular causes, nonfatal stroke, nonfatal myocardial infarction, or major bleeding (13% vs. 16%; HR 0.8, 95% CI 0.66 to 0.98) Secondary outcomes No significant difference in death from any cause (7% vs. 8%; HR 0.88, 95% CI 0.67 to 1.17) No significant difference in vascular death (3.2% vs. 4.4%; HR 0.75, 95% CI 0.51 to 1.1) No significant difference in major bleeding complications (2.6% vs. 3.9%; HR 0.67, 95% CI 0.44 to 1.03) Safety outcomes No significant difference in all major ischemic events. Significant difference in discontinuation of trial medication (34.5% vs. 13.4%). Conclusion In patients within 6 months of a TIA or minor ischemic stroke of presumed arterial origin, aspirin and dipyridamole were superior to aspirin alone with respect to death from all vascular causes, nonfatal stroke, nonfatal myocardial infarction, or major bleeding. Reference ESPRIT Study Group, Halkes PH, van Gijn J et al. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet. 2006 May 20;367(9523):1665-73. Open reference URL https://web.pathway.md/studies/recM11rZK4cqmMcZT 2/2