Secondary prevention of stroke

Abstract

Stroke disease remains a national priority due to the high morbidity and mortality. Good clinical practice dictates that risk factors are identified and corrected. Various therapeutic regimens have been tested in trials of sufficient strength to give answers. In the second European Stroke Prevention Study (ESPSZ), low dose aspirin (50 mg/d), sustained release dipyridamole (200 mg/d) were shown to reduce recurrence of stroke and TIA. The combination was twice as effective. Also in the Clopidogrel/aspirin Prevention of Recurrence of Ischaemic Events (CAPRIE) trial clopidogrel was shown to be superior to aspirin.

In clinical practice patients with stroke or TIA should be investigated rapidly, their risk factors corrected and appropriate drug regimens implemented.

Keywords

Aspirin dipyridamole secondary prevention stroke TIA.

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References

Algra A. and Van Gijn J. (1996). Aspirin at any dose above 30 mg offers only modest protection after cerebral ischaemia. J Neurol Neurosurg Psychia ; 80, 197-9

Anti-Platelet Trialist'S Collaboration (1994 ). Collaborative overview of randomised trials of anti-platelet therapy — 1: prevention of death, myocardial infarction and stroke by prolonged anti-platelet therapy in various categories of patients. BMJ; 308, 81-105

Barnett H J M , Ebasziw M. and Meldrum H.E. (1995). Drugs and surgery in the prevention of ischaemic stroke. New Engl J Med; 332, 238-48

Bath P. ( 1995). Stroke Therapy: Advances in Commercial Opportunities . Oxford UK: Connect Pharma Ltd , Oxford

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Caprie Steering Committee (1996). A randomised blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet; 348, 1329-39

Diener H. , Cunha L. , Forbes C. , Sivenius J. , Smets P. and Lowenthal A. (1996). European Stroke Prevention Study 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurolog Sci; 143, 1-13

Dutch Tia Trial Study Group (1991). A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischaemic attack or minor ischaemic stroke. New Engl J Med; 325,1261-6

Forbes C.D. (1997). Unpublished research Muller T.H. , Su C A P F , Weiserber-Ger H. , Brickyl R. , Nehmiz G. and Eisert W.G. (1990). Dipyridmole alone or combined with low-dose acetylsalicylic acid inhibits platelet aggregation in human whole blood ex vivo. Br J Clin Pharm; 30,179-86

Office Of Health Economics (1988). Stroke. London, UK: Office of Health Economics, No 89

10.

Salt Collaborative Group (1991). Swedish Aspirin Low dose Trial (SALT) of 75 mg of aspirin as secondary prophylaxis after cerebrovascular ischaemic events. Lancet; 338, 1345-9

11.

Uk-Tia Study Group (1991). United Kingdom Transient Ischaemic Attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychia; 54, 1044-54

Secondary prevention of stroke — an update

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