Abstract
There is continuing debate about the relative efficacy of low (< 100 mg per day), medium (300 to 325 mg per day), and high (> 900 mg per day) doses of aspirin in patients after a transient ischaemic attack or non-disabling stroke. The purpose of this study was to resolve the issue. Thus a minimeta-analysis was performed on data from 10 randomised trials of aspirin only v control treatment in 6171 patients after a transient ischaemic attack or nondisabling stroke. The data on the trials were listed in an appendix of the report on the second cycle of the Antiplatelet Trialists' Collaboration. There was virtually no difference in relative risk reduction for low, medium, and high doses of aspirin (13%, 9%, and 14% respectively). This equivalence corresponds with the results of the UK-TIA trial in a direct comparison of 300 and 1200 mg. The Dutch TIA trial showed no difference in efficacy of 30 and 283 mg. It is concluded that aspirin at any dose above 30 mg daily prevents 13% (95% confidence interval 4-21) of vascular events and that there is a need for more efficacious drugs.
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- Alberts M. J., Dawson D. V., Massey E. W. A follow-up survey of clinical practices for the use of heparin, warfarin, and aspirin. Neurology. 1994 Apr;44(4):618–621. doi: 10.1212/wnl.44.4.618. [DOI] [PubMed] [Google Scholar]
- Algra A., van Gijn J. Science unblinded. Lancet. 1994 Apr 23;343(8904):1040–1040. doi: 10.1016/s0140-6736(94)90161-9. [DOI] [PubMed] [Google Scholar]
- Barnett H. J., Eliasziw M., Meldrum H. E. Drugs and surgery in the prevention of ischemic stroke. N Engl J Med. 1995 Jan 26;332(4):238–248. doi: 10.1056/NEJM199501263320408. [DOI] [PubMed] [Google Scholar]
- Bousser M. G., Eschwege E., Haguenau M., Lefaucconnier J. M., Thibult N., Touboul D., Touboul P. J. "AICLA" controlled trial of aspirin and dipyridamole in the secondary prevention of athero-thrombotic cerebral ischemia. Stroke. 1983 Jan-Feb;14(1):5–14. doi: 10.1161/01.str.14.1.5. [DOI] [PubMed] [Google Scholar]
- Boysen G., Sørensen P. S., Juhler M., Andersen A. R., Boas J., Olsen J. S., Joensen P. Danish very-low-dose aspirin after carotid endarterectomy trial. Stroke. 1988 Oct;19(10):1211–1215. doi: 10.1161/01.str.19.10.1211. [DOI] [PubMed] [Google Scholar]
- Dyken M. L., Barnett H. J., Easton J. D., Fields W. S., Fuster V., Hachinski V., Norris J. W., Sherman D. G. Low-dose aspirin and stroke. "It ain't necessarily so". Stroke. 1992 Oct;23(10):1395–1399. doi: 10.1161/01.str.23.10.1395. [DOI] [PubMed] [Google Scholar]
- Fields W. S., Lemak N. A., Frankowski R. F., Hardy R. J. Controlled trial of aspirin in cerebral ischemia. Part II: surgical group. Stroke. 1978 Jul-Aug;9(4):309–319. doi: 10.1161/01.str.9.4.309. [DOI] [PubMed] [Google Scholar]
- Fields W. S., Lemak N. A., Frankowski R. F., Hardy R. J. Controlled trial of aspirin in cerebral ischemia. Stroke. 1977 May-Jun;8(3):301–314. doi: 10.1161/01.str.8.3.301. [DOI] [PubMed] [Google Scholar]
- Guiraud-Chaumeil B., Rascol A., David J., Boneu B., Clanet M., Bierme R. Prévention des récidives des accidents vasculaires cérébraux ischémiques par les anti-agrégants plaquettaires. Résultats d'un essai thérapeutique contrôlé de 3 ans. Rev Neurol (Paris) 1982;138(5):367–385. [PubMed] [Google Scholar]
- Reuther R., Dorndorf W., Loew D. Behandlung transitorisch-ischämischer Attacken mit Azetylsalizylsäure Ergebnisse einer Doppelblindstudie. MMW Munch Med Wochenschr. 1980 May 23;122(21):795–798. [PubMed] [Google Scholar]
- Sorensen P. S., Pedersen H., Marquardsen J., Petersson H., Heltberg A., Simonsen N., Munck O., Andersen L. A. Acetylsalicylic acid in the prevention of stroke in patients with reversible cerebral ischemic attacks. A Danish cooperative study. Stroke. 1983 Jan-Feb;14(1):15–22. [PubMed] [Google Scholar]
- van Gijn J., Warlow C. P., Norrving B. Low-dose aspirin and stroke. Stroke. 1993 Mar;24(3):476–477. doi: 10.1161/01.str.24.3.476. [DOI] [PubMed] [Google Scholar]