Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Horner, S; Schmidbauer, M; Schnaberth, G; Weiss, S; Niederkorn, K; Schmidt, R; Homann, CN; Ott, E; Hartung, HP.
Antiplatelet therapy in secondary ischemic stroke prevention
NEUROPSYCHIATRIE 2000 14: 12-22.
Web of Science
- Führende Autor*innen der Med Uni Graz
- Horner Susanna
- Co-Autor*innen der Med Uni Graz
- Homann Carl
- Niederkorn Kurt
- Ott Erwin
- Schmidt Reinhold
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- Abstract:
- The primary purpose of this overview is to provide an update on antiplatelet drugs evaluated in clinical trials in order to evaluate treatment strategies in secondary stroke prevention. Acetylsalicylic acid (ASS) has been the standard reference agent in cerebrovascular disease and decreases events up to 25%. High-dose versus low-dose trials confirmed the lack of dose-response relationship. Based on the results of ESPS-2 the lowest effective dose of ASS is 50 mg daily. Impressive beneficial results have been reported from the ESPS-2 concerning the role of a combination therapy with a relative risk reduction (RR) of 37% for the outcome of stroke with ASS plus dipyridamole (50/400 mg) in comparison to 18% for ASS (50 mg) alone. TASS confirmed a higher benefit of ticlopidine versus ASS with a RR of 21% (p = 0.024) for TIA and stroke, however, ticlopidine therapy was associated with neutropenia. CAPRIE compared the efficacy of clopidogrel (75 mg) versus ASS (325 mg) for a cluster of ischemic events and showed a modest increase in effectiveness, an RR of 8.7 (p = 0.043) for clopidogrel. Tn summary, ASS (50 - 325 mg daily) can be suggested for first choice in patients with primary stroke. An alternative to ASS is ASS plus dipyridamole in patients with TIA, stroke recurrence or thienopyridine intolerance. Clopidogrel is suggested in patients with combined atherosclerotic diseases and replaces ticlopidine when ASS has failed or is not tolerated.
- Find related publications in this database (Keywords)
- ischemic stroke
- secondary stroke prevention
- antiplatelet agents
- therapeutic guidelines