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Evidence summaries

Dipyridamole for Preventing Vascular Events

The combination of aspirin and dipyridamole compared to aspirin alone reduces the risk of vascular events in patients with cerebral ischaemia. Dipyridamole alone is not more effective than aspirin alone in preventing vascular events or vascular death. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 29 studies with a total of 23 019 patients, among whom 1503 vascular deaths and 3438 fatal and non-fatal vascular events occurred during follow-up. Compared with control, dipyridamole had no effect on vascular death (RR 0.99, 95% CI 0.87 to 1.12) in the presence or absence of another antiplatelet drug. This result was not influenced by the dose of dipyridamole or type of presenting vascular disease. Compared with control, dipyridamole appeared to reduce the risk of vascular events (RR 0.88, 95% CI 0.81 to 0.95) in the presence or absence of another antiplatelet drug, but this benefit was statistically significant only in patients presenting with cerebral ischaemia. There was no difference between dipyridamole and aspirin in the avoidance of vascular death (RR 1.08, 95% CI 0.85 to 1.37) or the prevention of vascular events (RR 1.02, 95% CI 0.88 to 1.18; 3 trials). The combination of dipyridamole plus aspirin was associated with a lower risk of further vascular events than aspirin alone (RR 0.87, 95% CI 0.79 to 0.96; 13 studies) among patients presenting with arterial vascular disease, especially ischaemic stroke or TIA.

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    References

    • De Schryver EL, Algra A, van Gijn J. Dipyridamole for preventing stroke and other vascular events in patients with vascular disease. Cochrane Database Syst Rev 2007 Jul 18;(3):CD001820. [PubMed]

Primary/Secondary Keywords