Among patients with TIA or minor stroke who can be treated within 24 hours after the onset of symptoms, the combination of clopidogrel and aspirin is superior to aspirin alone for reducing the risk of stroke in the first 90 days and does not increase the risk of hemorrhage. (Funded by the Ministry of Science and Technology of the People's Republic of China; CHANCE ClinicalTrials.gov number, NCT00979589.).

Protection by mild hypothermia has previously been associated with better mitochondrial preservation and suppression of the intrinsic apoptotic pathway. It is also known that the brain may undergo apoptotic death via extrinsic, or receptor‐mediated pathways, such as that triggered by Fas/FasL. Male Sprague‐Dawley rats subjected to 2 h middle cerebral artery occlusion with 2 h intraischemic mild hypothermia (33°C) were assayed for Fas, FasL and caspase‐8 expression. Ischemia increased Fas, but decreased FasL by ∼ 50–60% at 6 and 24 h post‐insult. Mild hypothermia significantly reduced expression of Fas and processed caspase‐8 both by ∼ 50%, but prevented ischemia‐induced FasL decreases. Fractionation revealed that soluble/shed FasL (sFasL) was decreased by hypothermia, while membrane‐bound FasL (mFasL) increased. To more directly assess the significance of the Fas/FasL pathway in ischemic stroke, primary neuron cultures were exposed to oxygen glucose deprivation. Since FasL is cleaved by matrix metalloproteinases (MMPs), and mild hypothermia decreases MMP expression, treatment with a pan‐MMP inhibitor also decreased sFasL. Thus, mild hypothermia is associated with reduced Fas expression and caspase‐8 activation. Hypothermia prevented total FasL decreases, and most of it remained membrane‐bound. These findings reveal new observations regarding the effect of mild hypothermia on the Fas/FasL and MMP systems.