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April 16, 2003

Reducing the Risk of Stroke

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(15):1927-1929. doi:10.1001/jama.289.15.1927

To the Editor: Dr Straus and colleagues1 stated that "the Antiplatelet Trialists' Collaboration [ATC]2 did not find that adding dipyridamole to aspirin resulted in significant benefit over the use of aspirin alone, but they noted that a single randomized trial found that the addition of extended-release dipyridamole to aspirin decreased the risk of death significantly." The ATC authors claimed that the results of this "single randomized trial" (ESPS-2),3 which demonstrated significant reduction in stroke risk, was inconsistent with preceding negative trials of dipyridamole plus aspirin for cardiovascular disease prevention and that its results may have arisen "largely or wholly by the play of chance."2