Document Detail


Antiplatelet agents for secondary prevention of ischemic stroke.
MedLine Citation:
PMID:  11675854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review and summarize the efficacy, mechanisms of action, and cost of the options available when choosing antiplatelet agents for secondary stroke prevention. DATA SOURCES: This article is based on a review of the literature found with MEDLINE, CINAHL, and Cochrane Reviews (1980-June 2000) and abstracts from relevant international scientific meetings. We searched for the terms aspirin, ticlopidine, dipyridamole, antiplatelet, and clopidogrel. STUDY SELECTION: English-language articles, both reviews and original studies, were evaluated, and all information considered relevant was included in this review. In addition, guidelines from the American Heart Association are included. DATA SYNTHESIS: Aspirin is a relatively inexpensive and effective agent for secondary stroke prevention, and lower doses of aspirin appear as effective as higher doses. Ticlopidine has been used alone or in combination with aspirin, but serious adverse effects have limited its use. Clopidogrel has emerged as a safe and effective alternative to ticlopidine and lacks some of the serious adverse effects associated with ticlopicine, but is not superior to aspirin in secondary stroke prevention. Unlike previous studies, one recent trial showed that dipyridamole in combination with aspirin is superior to aspirin alone. CONCLUSIONS: Antiplatelet therapy is a key component of secondary prevention strategies in ischemic stroke. While aspirin has been the cornerstone in the management of stroke, other classes of antiplatelet drugs present new opportunities to optimize antiplatelet therapy.
Authors:
A Majid; N Delanty; J Kantor
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  35     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-24     Completed Date:  2002-03-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1241-7     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA. arshadmajid@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aspirin / administration & dosage,  adverse effects,  therapeutic use
Clinical Trials as Topic
Cost-Benefit Analysis
Dipyridamole / administration & dosage,  adverse effects,  therapeutic use
Humans
Myocardial Ischemia / prevention & control*
Platelet Aggregation Inhibitors / therapeutic use*
Stroke / prevention & control*
Ticlopidine / adverse effects,  analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 58-32-2/Dipyridamole; 90055-48-4/clopidogrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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