In patients with recent ischemic CVA or TIA, does clopidogrel plus aspirin reduce recurrent events when compared to clopidogrel alone? Combination therapy conferred a great risk of major bleeding, including life-threatening hemorrhage. The evidence-based use of aspirin in cerebrovascular disease was initially based upon early trials such as IST and Chinese Acute Stroke Trial  , which demonstrated a clear benefit of the antiplatelet agent in secondary prevention of ischemic CVA and TIA. This was confirmed in the Antithrombotic Trialists' Collaboration meta-analysis. CURE and CREDO  demonstrated a clear benefit of combination therapy with aspirin plus clopidogrel compared to aspirin alone in CAD, but combination therapy had not yet been studied in cerebrovascular disease. At a mean follow-up of 18 months, MATCH failed to demonstrate a statistically significant difference in efficacy between the two groups.
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