Annals of Indian Academy of Neurology
  Users Online: 895 Home | About the Journal | InstructionsCurrent Issue | Back IssuesLogin      Print this page Email this page  Small font size Default font size Increase font size

Year : 2010  |  Volume : 13  |  Issue : 3  |  Page : 234

Author's reply

Department of Neurology, AIIMS, New Delhi - 110 029, India

Date of Web Publication5-Oct-2010

Correspondence Address:
M. V. Padma Srivastava
Department of Neurology, AIIMS, New Delhi - 110 029
Login to access the Email id

Source of Support: None, Conflict of Interest: None

PMID: 21085542

Rights and PermissionsRights and Permissions


How to cite this article:
Srivastava MP. Author's reply. Ann Indian Acad Neurol 2010;13:234

How to cite this URL:
Srivastava MP. Author's reply. Ann Indian Acad Neurol [serial online] 2010 [cited 2020 Jul 6];13:234. Available from:

I thank the author for the very relevant observations made in the letter.

  1. Regarding the first comment, it is true that the Clopidogrel versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) study showed a relative risk reduction of 8.7% in favor of clopidogrel, which certainly is not an 'immense' benefit over and above that with aspirin. I apologize for the typing error.
  2. Regarding the second comment, the concepts of antiplatelet 'resistance' and 'failure' are still evolving. I agree that the overall risk reduction with aspirin is so small that while on aspirin, recurrence is very possible. However, all things being equal, if on an adequate prophylaxis (with whatever is possible, including risk factor reduction, etc.), a patient continues to have recurrent events, it does call for a change in strategy rather than persisting with the same course of action.
  3. Regarding the third comment, I do not think that we have a final word on 'any' aspect of antiplatelet therapy as of today. One of the major criticisms of the European Stroke prevention Study (ESPS) has been the choice of aspirin dosage. In (European and Australasian Stroke Prevention in Reversible Ischemia Trial (ESPRIT) the dosage did vary and some received up to 325 mg of aspirin. In Management of Atherothrombosis with Clopidogrel in High risk patients with recent transient ischemic attacks (TIAs) or ischemic stroke (IS) (MATCH) the dosage of aspirin was 75 mg, which is in the 'accepted' range for prophylaxis and was compared with clopidogrel. This review is essentially an attempt to point out some aspects of the existing controversies, confusion, and a definite need for further evidence in many areas of stroke prophylaxis.


Print this article  Email this article
Previous article Next article


   Next article
   Previous article 
   Table of Contents
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (793 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 Article Access Statistics
    PDF Downloaded30    
    Comments [Add]    

Recommend this journal