| Antiplatelet agents in the secondary prevention of stroke: meta-analysis of the randomized control trials. | |
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MedLine Citation:
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PMID: 3284017 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Randomized control trials of antiplatelet agents in the prevention of stroke following transient ischemic attacks have had conflicting results. The decision to employ aspirin instead of placebo as the control regimen in trials testing newer antiplatelet agents emphasizes the need for an accurate estimate of the efficacy of older drugs. A meta-analysis of seven randomized control trials comparing aspirin and/or sulfinpyrazone or dipyridamole with placebo was performed. For aspirin compared with placebo, a nonsignificant reduction in stroke of 15% (odds ratio 0.85, 95% confidence interval 0.60-1.19; chi 2 = 0.78, p greater than 0.30) was found. For aspirin combined with sulfinpyrazone or dipyridamole compared with placebo, a 39% reduction in stroke was observed (odds ratio 0.61, 95% confidence interval 0.39-0.95; chi 2 = 4.22, p less than 0.05); at the same time a 350% increase in gastrointestinal hemorrhage or peptic ulcer was noted (odds ratio 3.5, 95% confidence interval 1.26-9.75; chi 2 = 4.61, p less than 0.05). A trend in reduction of strokes for men was observed (odds ratio 0.58, 95% confidence interval 0.32-1.07; chi 2 = 2.52, p less than 0.15) for any regimen containing aspirin. The significant benefit of aspirin-combination therapy on stroke must be interpreted cautiously because of a number of possible biases. It is still conceivable that aspirin alone may decrease the incidence of stroke by as much as 40%, but a sample of greater than 13,000 patients would be needed to confirm the benefit observed in our analysis. |
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Authors:
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P C Sze; D Reitman; M M Pincus; H S Sacks; T C Chalmers |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 19 ISSN: 0039-2499 ISO Abbreviation: Stroke Publication Date: 1988 Apr |
Date Detail:
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Created Date: 1988-06-02 Completed Date: 1988-06-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 436-42 Citation Subset: IM |
Affiliation:
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Clinical Trials Unit, Mount Sinai School of Medicine, City University of New York, New York. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aspirin
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therapeutic use Cerebrovascular Disorders / etiology, prevention & control* Clinical Trials as Topic Dipyridamole / therapeutic use Drug Combinations Humans Ischemic Attack, Transient / complications Platelet Aggregation Inhibitors / adverse effects, therapeutic use* Random Allocation Sulfinpyrazone / therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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LM03116/LM/NLM NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Drug Combinations; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 57-96-5/Sulfinpyrazone; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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