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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