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The review characterizes the role of acetylsalicylic acid in the prevention of stroke in patients with clinical manifestations of atherosclerosis or a potential source of thromboembolism from the left-sided cardiac chambers. It analyzes approaches to preventing the most common complications associated with the use of acetylsalicylic acid.

About the Author

I. S. Yavelov
City Clinical Hospital Twenty Nine
Russian Federation


1. <div><p>Bhatt D.L., Steg G., Ohman E.M. et al., for the REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 2006;295:180-9.</p><p>Steg G., Bhatt D.L., Wilson P.W.F. et al., for the REACH Registry Investigators. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007;297:1197-206.</p><p>Alberts M.J., Bhatt D.L., Mas J.-L. et al., for the REACH Registry Investigators. Three-year follow up and event rates in the international reduction of atherothrombosis for coronary health registry. Eur Heart J 2009; doi: 10.1093/eurheartj/ehp355.</p><p>Antithrombotic TrialistsX (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009;373:1849-60.</p><p>Adams R.J., Albers G., Alberts M.J. et al. Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke 2008;39:1647-52.</p><p>The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis 2008;25:457-507.</p><p>A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). 2008 Focused Update Incorporated into the ACC/AHA 2006 Guidelines for the management of patients with valvular heart disease. JACC 2008;52:e1-142.</p><p>Hart R.G., Pearce L.A., Aguilar M.I. Metaanalysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146:857-67.</p><p>Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. Eur Heart J 2008;29:2909-45.</p><p>Focused Update of the ACC/AHA 2004 Guidelines for the management of patients With ST-elevation myocardial infarction. a report of the American college of Cardiology/American heart association task force on practice guidelines. JACC 2008;51:210-47.</p><p>Salem D.N., O'Gara P.T., Madias C.,Pauker S.G. Valvular and structural heart disease. American college of chest physicians evidence- based clinical practice guidelines (8th Edition). Chest 2008;133:593-629.</p><p>Singer D.E., Albers G.W., Dalen J.E. et al. Antithrombotic therapy in atrial fibrillation. American college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest 2008;133:546-592.</p><p>Albers G.W., Amarenco P., Easton J.D. et al. Antithrombotic and thrombolytic therapy for ischemic stroke. American college of chest physicians evidence-based clinical practice guidelines (8th Edition). Chest 2008;133:630-669.</p><p>ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American college of cardiology/American heart association task force on practice guidelines and the European society of Cardiology committee for practice guidelines (Writing committee to revise the 2001 guidelines for the management of patients with atrial fibrillation). JACC 2006;48:854-906.</p><p>Healey J., Hart R.G., Pogue J. et al. Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events (ACTIVE-W). Stroke 2008;39:1482-6.</p><p>Stroke prevention in atrial fibrillation study. Final results. Circulation 1991;84:527-39.</p><p>Hurlen M., Abdelnoor M., Smith P. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med 2002;347:969-74.</p><p>Dentali F., Douketis J.D., Lim W., Crowther M. Combined aspirin - oral anticoagulant therapy compared with oral anticoagulant therapy alone among patients at risk for cardiovascular disease. A meta-analysis of randomized trials. Arch Intern Med 2007;167:117-24.</p><p>Andreotti F., Testa L., Biondi-Zoccai G.G.L., Crea F. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25 307 patients. Eur Heart J 2006; 27:519-26.</p><p>Patrono C., Baigent C., Hirsh J., Roth G. Antiplatelet drugs. American college of chest physicians evidence-based clinical practice guidelines (8th Edition). Chest 2008;133:199-233.</p><p>ACCF/ACG/AHA 2008 Expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. A Report of the American college of cardiology foundation task force on clinical expert consensus documents. Circulation 2008;118:1894-909.</p><p>Lanas A., Garcia-Rodriguez L.A., Arroyo M.T. et al., on behalf of the investigators of the Asociacion Espanola de Gastroenterologia (AEG). Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo-oxygenase-2 inhibitors, traditional non-aspirin non-steroidal anti-inflammatory drugs, aspirin and combinations. Gut 2006;55:1731-8.</p><p>Patrono C., Garcia Rodriguez L.A., Landolfi R., Baigent C. Low-dose aspirin for the prevention of atherothrombosis. N Engl J Med 2005;353:2373-83.</p><p>Hansson L., Zanchetti A., Carruthers S.G. et al., for the HOT Study Group. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998;351:1755-62.</p><p>Serebruany V.L., Steinhubl S.R., Berger P.B. et al. Analysis of Risk of bleeding complication after different doses of aspirin in 192036 patients enrolled in 31 Randomized Controlled Trials. Am J Cardiol 2005;95:1218-22.</p><p>Steinhubl S.R., Bhatt D.L., Brennan D.M. et al., on behalf of the CHARISMA Investigators aspirin to prevent cardiovascular disease: the association of aspirin dose and clopidogrel with thrombosis and bleeding. Ann Intern Med 2009;150:379-86.</p><p>Peters R.J.G., Mehta S.R., Fox K.A.A. et al. for the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators. Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes. Observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Study. Circulation 2003;108:1682-7.</p><p>Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71-86.</p><p>Dutch TIA Trial Study Group. A compari- son of two doses of aspirin (30 mg vs 283 mg a day) in patients after transient ischemic attack or minor ischemic stroke. N Engl J Med 1991;325:1261-6.</p><p>Diener H.C., Cunha L., Forbes C. et al. European stroke prevention study: II. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996;143:1-13.</p><p>Chuen K., Lam H.K., Chu R.M. et al. Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. N Engl J Med 2002;346:2033-8.</p><p>Chan F.K., Ching J.Y., Hung L.C. et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 2005;352:238-44.</p><p>Lai K.C., Chu K.M., Hui W.M. et al. Esomeprazole with aspirin versus clopidogrel for prevention of recurrent gastrointestinal ulcer complications. Clin Gastroenterol Hepatol 2006;4:860-5.</p><p>Shelley Wood. COGENT: No CV events but significant GI benefits of PPI omeprazole. </p><p>Taha A.S., McCloskey C., Prasad R., Bezlyak V. Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial. Lancet 2009;374:119-25.</p><p>Kelly J.P., Kaufman D.W., Jurgelon J.M. et al. Risk of aspirin-associated major upper-gastrointestinal bleeding with enteric-coated or buffered product. Lancet 1996;348:1413-6.</p><p>Derry S., Loke Y.K. Risk of gastrointestinalhaemorrhage with long term use of aspirin: metaanalysis. BMJ 2000;321:1183-7.</p><p>Walker J., Robinson J., Stewart J., Jacob S. Does enteric-coated aspirin result in a lower inci- dence of gastrointestinal complications compared to normal aspirin? Interactive cardioVascular and Thoracic Surgery 2007;6:519-22.</p><p>De Abajo F.J., Garcia Rodriguez L.A. Risk of upper gastrointestinal bleeding and perforation associated with low-dose aspirin as plain and enteric-coated formulations. BMC Clin Pharmacol 2001;1:1.</p><p>McQuaid K.R., Laine L. Systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials. Am J Med 2006;119:624-38.</p><p>Cox D., Maree A.O., Dooley M. et al. Effect of enteric coating on antiplatelet activity of low- dose aspirin in healthy volunteers. Stroke 2006;37:2153-8.</p></div><br />

For citation:

Yavelov I.S. ACETYLCALICYLIC ACID AND PREVENTION OF STROKE IN HIGH-RISK GROUP PATIENTS. Neurology, Neuropsychiatry, Psychosomatics. 2009;1(3-4):64-68. (In Russ.)

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