<International Circulation>: The ACTIVE A trial showed that in patients unable or unwilling to take warfarin， the combination of aspirin plus clopidogrel compared with aspirin alone reduced the risk for stroke by 28%， although it also increased the risk for major bleeding events. Do you think that there was a net benefit in favor of dual antiplatelet therapy?

Prof. Diener: The combination of aspirin and clopidogrel is superior to aspirin in patients who do not want to take warfarin or the treating physician thinks they should not take warfarin. However， this effect was almost completely offset by a higher bleeding rate so many physicians are reluctant to the combination of aspirin and clopidogrel.