European Stroke Prevention Study-2 results: serendipitous demonstration of neuroprotection induced by endogenous adenosine accumulation?

In patients with prior stroke or transient ischaemic attack, anti-platelet treatment with dipyridamole substantially reduced stroke recurrence, with a beneficial effect comparable to and additive with that induced by aspirin (the European Stroke Prevention Study-2). Eugenio Picano and Maria Abbracchio present here a platelet-independent hypothesis, according to which cardiovascular and neuroprotective actions achieved by dipyridamole through chronic elevation of endogenous adenosine levels may have contributed to the therapeutic success of this study.