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Nondisabling cerebrovascular events represent the largest group of cerebrovascular disease with a high risk of recurrent stroke. A recent trial demonstrated that dual-antiplatelet therapy (clopidogrel and aspirin), compared with aspirin monotherapy, reduced the risk of recurrent stroke and was not associated with increased risk of hemorrhagic events. Apixaban, a new oral anticoagulant, has been proven to be as safe and effective as traditional anticoagulants while carrying significantly less risk of intracranial hemorrhage. Patients with transient ischemic attack (TIA)/minor stroke might benefit from apixaban treatment; therefore, an adequately powered randomized study is needed.

clinical drug investigation

Initial 3-Weeks’ Apixaban Versus Dual-Antiplatelet Therapy (Clopidogrel and Aspirin) Followed by Clopidogrel Alone in High-Risk Patients with Acute Non-Disabling Cerebrovascular Events (ADANCE): Study Protocol for a Randomized Controlled Trial