TEC: Evidence Based Therapeutics
Therapeutics Education Collaboration
Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 67: A clot, a clot, I want it not – secondary stroke prevention with antiplatelets

In episode 67, we address ischemic stroke of arterial origin and go over some core therapies (ASA, dipyridamole, clopidogrel and warfarin).  We also discuss complications of anti-thrombotics and the options for patients with a GI bleed on ASA.  Although Peter attempts to guide us through the maze of evidence, all three of us get lost and have trouble finding our way back. Mike rightly corrects James about one of his comments and James responds in a purely professional manner.

Show Notes

1) ASA post-stroke – low dose

ATTC 2009

Lancet 2009;373:1849–60

2) Clopidogrel versus ASA


Lancet 1996;348:1329–39

3) ASA and clopidogrel versus clopidogrel


NEJM 2006;354:1706-17


Lancet 2004;364:331–37

4) ASA versus warfarin post-stroke


NEJM 2001;345:1444-51

5) Dipyridamole plus ASA


Thromb Res 1998;92:S1-S6


Lancet 2006;367:1665-75



NEJM 2008;359:1238-51

7) GI bleeding and ASA

PPI added to ASA versus clopidogrel alone

NEJM 2005; 352:238-44

H. pylori eradication versus proton pump inhibitor

NEJM 2001;344:967-73

H. pylori eradication plus proton pump inhibitor versus H. pylori eradication alone

NEJM 2002;346:2033-8

Clopidogrel plus a PPI – interaction or not

CMAJ 2009;180:713-8

Listening to this episode is for premium podcast members only. If you already have a membership, login to your account. If you aren't yet a premium subscriber, sign up today!


Upcoming Events

Practical Evidence for Informed Practice (PEIP) – October 22-23, 2021

This will be a live-streamed course from Edmonton, AB. Registration Opens August 2021

BS Medicine Podcast

BedMed: The High Blood Pressure Study

This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)

PEER Tools