Table IV.

Relevant clinical trials of antiplatelet therapy in elderly patients with ischaemic stroke

Name	Population	Treatment	Key clinical finding	Findings in subgroups by age
CAPRIE[26]	19 185 patients with a history of ischaemic stroke, MI or PAD. Mean age 62.5 years	ASA vs clopidogrel	Clopidogrel reduced the absolute risk of the primary outcomea by 0.51% compared with ASA (p = 0.043)	No published data
MATCH[27]	7599 patients with TIA or ischaemic stroke within 3 months. Mean age 66.3 years	Clopidogrel + placebo vs clopidogrel + ASA	Clopidogrel + ASA did not significantly reduce the absolute risk of the primary outcomeb (1.0%, p = 0.244) but did significantly increase the risk of life-threatening, major and minor bleeding (p < 0.0001) compared with clopidogrel alone	No significant differences between age <65 (ARR 2.3% ; HR 0.86; 95% CI 0.64, 1.02) and ≥65 years (ARR 0.3% ; HR 1.0; 95% CI 0.86, 1.12)
CHARISMA[28]	15 603 patients with clinically evident cardiovascular disease or multiple risk factors. Mean age 64 years	ASA + placebo vs ASA + clopidogrel	Clopidogrel + ASA had no effect on the primary outcomea (ARR 0.5% ; RR 0.93; 95% CI 0.83, 1.05) and increased the absolute risk of moderate bleeding events by 0.8% (p < 0.001) compared with ASA alone	No difference in age <75 (HR 0.9; 95% CI 0.8, 1.05) vs ≥75 years (HR 0.91; 95% CI 0.75, 1.2)
ESPS-2[29]	6602 patients with TIA or ischaemic stroke within 3 months. Mean age 66.7 years	Placebo vs ASA vs dipyridamole vs ASA/ER dipyridamole	ASA/ER dipyridamole reduced the absolute risk of the primary outcomec by 12.9% (p = 0.056) compared with ASA alone and by 10.7% (p = 0.073) compared with dipyridamole alone	No published data
ESPRIT[30]	2739 patients with a TIA or minor stroke within 6 months. Mean age 63 years	ASA + placebo vs ASA/ER dipyridamole	ASA/ER dipyridamole resulted in an ARR of 1.0% per year in the primary outcomed (95% CI 0.1, 1.8) compared with ASA alone	No significant difference between age ≤65 (HR 0.9; 95% CI 0.7, 1.1) and >65 years (HR 0.8; 95% CI 0.65, 1.0)
PRoFESS[31]	20 332 patients with ischaemic stroke <90 days before randomization. Mean age 66.1 years	ASA/ER dipyridamole vs clopidogrel	No significant difference in primary outcome (ASA/ER dipyridamole 9%, clopidogrel 8.8%). Did not meet statistical criteria for non-inferiority for ASA/ER dipyridamole	No significant difference between treatments among age <65 years, age ≥65 years to < 75 years or age ≥75 years

^aIschaemic stroke, MI, cardiovascular death.

^bIschaemic stroke, MI, cardiovascular death, rehospitalization for acute ischaemia.

^cIschaemic stroke or cardiovascular death.

^dIschaemic stroke, MI, cardiovascular death, major bleeding.

ARR = absolute risk reduction; ASA = aspirin (acetylsalicylic acid); ER = extended-release; HR = hazard ratio; MI = myocardial infarction; PAD = peripheral arterial disease; RR = relative risk; TIA = transient ischaemic attack.