MATCH: Management of Atherothrombosis with Clopidogrel in High-Risk Patients with Recent Transient Ischemic Attack or Ischemic Stroke
Platelets play a key role in the pathogenesis of atherosclerosis and thrombosis, leading to transient ischemic attack (TIA) and stroke. Aspirin is an antiplatelet drug that reduces the risk of stroke, myocardial infarction (heart attack), and death by approximately 15% in patients with a history of atherosclerotic heart disease or cerebrovascular disease. Clopidogrel is an antiplatelet drug with a different mechanism of action that is slightly more effective than aspirin in reducing the risk of stroke, myocardial infarction, or vascular death. Simultaneous aspirin and clopidogrel is more effective than aspirin alone in reducing the risk of stroke, myocardial infarction, or vascular death and is safe for patients with myocardial infarction or unstable angina pectoris. It is unknown whether the combination of clopidogrel and aspirin is more effective than clopidogrel alone to prevent stroke, myocardial infarction, and death in patients who present with stroke or TIA. The primary objective of MATCH is to compare the efficacy of clopidogrel and aspirin with clopidogrel alone for preventing stroke, myocardial infarction, and death.
Adults with ischemic stroke or TIA within the previous 3 months will be eligible for MATCH. Participants must also be considered at high-risk of recurrent events because they previously have had ischemic stroke, myocardial infarction, angina pectoris, symptomatic peripheral arterial disease, or diabetes mellitus within the past 3 years. Patients who have a condition that is associated with an increased risk of bleeding or whose CT or MRI scan shows cerebral hemorrhage or non-ischemic neurologic disease are not eligible to participate.
MATCH is a multicenter, randomized, double-blind study in patients with cerebrovascular symptoms who are at high risk of recurrent ischemic events. Patients will be randomized to receive either clopidogrel 75 mg daily plus placebo or clopidogrel 75 mg daily plus aspirin 75 mg daily. Approximately 7,600 total patients will be randomized at 450 centers worldwide (70 centers in the US). Patients will be followed for development of clinical events (vascular death, myocardial infarction, ischemic stroke, or rehospitalization for acute ischemic events). The total duration of treatment will be about 18 months. MATCH started recruiting in the Clinical Trials Network in November 2001.