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Acetylsalicylic acid in the prevention and treatment of ischemic stroke

https://doi.org/10.14412/2074-2711-2010-89

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Abstract

The paper outlines indications for the use of acetylsalicylic acid (ASC) to prevent and treat ischemic stroke. A study of the effect of this agent in the primary prevention of stroke has demonstrated the obligatory identification of a category of individuals at higher risk for ischemic cerebral complications. The early initiation of ASC therapy in the acutest phase of ischemic stroke results in a significant reduction in mortality, risk for restroke, and neurological improvement. When used in the secondary prevention of noncardioembolic stroke, ASC belongs to the most studied antiplatelet agents that additionally reduce the rate of restroke or death.

About the Author

A. V. Fonyakin
Neurology Research Center, Russian Academy of Medical Sciences
Russian Federation
Moscow


References

1. <div><p>Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Клинические рекомендации ВНОК. Кардиоваск. тер. и профилактика 2009; 8(6; прил. 3).</p><p>Моисеев В.С., Сумароков А.В. Болезни сердца. Руководство для врачей. М.: Универсум паблишинг, 2001.</p><p>Антитромботическая терапия у больных со стабильными проявлениями атеротромбоза. Российские рекомендации. Кардиоваск. тер. и профилактика 2009; 8 (прил. 6).</p><p>Steering Committee of the Physicians Health Study Research Group. Final report on the aspirin component of the ongoing physicians' health study. N Engl J Med 1989; 321: 129-35.</p><p>Peto R., Gray R., Collins R. et al. Randomized trial of prophylactic daily aspirin in British male doctors. Br Med J (Clin Res Ed) 1988; 296: 313-6.</p><p>The Medical Research Council's General Practice Research Framework. Thrombosis prevention trial: randomized trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischemic heart disease in men at increased risk. Lancet 1998; 351: 233-41.</p><p>Hansson L., Zanchetti A., Carruthers S.G. et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomized trial. Lancet 1998; 351: 1755-63.</p><p>Collaborative Group of the Primary Prevention Project (PPP). Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomized trial in general practice. Lancet 2001; 357: 89-95.</p><p>Ridker P.M., Cook N.R., Lee I.M. et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 2005; 352: 1293-304.</p><p>Antithrombotic Tralists' Collaboration. Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction and stroke in high risk patients. Br Med J 2002; 324: 71-86.</p><p>Levin R.I. The puzzle of aspirin and sex. N Engl J Med 2005; 352: 1366-8.</p><p>Becker D.M., Segal J., Vaidya D. et al. Sex differences in platelet reactivity and response to low-dose aspirin therapy. JAMA 2006; 295: 1420-7.</p><p>Berger J.C., Roncaglioni M.C., Avanzini F. et al. Aspirin for the primary prevention of cardiovascular events in women and men. A sex- specific meta-analysis of randomized controlled trials. JAMA 2006; 295: 306-13.</p><p>Явелов И.С. Антитромботическая терапия в первичной профилактике инсульта. Неврология, нейропсихиатрия и психосоматика 2009; 1: 30-4.</p><p>Bousser M.-G. Antithrombotic agents in the prevention of ischemic stroke. Cerebrovasc Dis 2009; 27(Suppl. 3): 12-9.</p><p>Campbell C.L., Smyth S., Montalescot G., Steinhubl S. Aspirin dose for the prevention of cardiovascular disease. A systematic review. JAMA 2007; 297: 2018-24.</p><p>Greving J.P., Buskens E., Koffijberg H., Algra A. Cost effectiveness of aspirin treatment in the primary prevention of cardiovascular disease events in subgroups based on age, gender and varying cardiovascular risk. Circulation 2008; 117: 2875-83.</p><p>Goldstein L.D., Adams R., Alberts M.J. et al. Primary prevention of ischemic stroke. Stroke 2006; 37: 1583-633.</p><p>Conroy R.M., Pyorala K., Fitzgerald A.P. et al. SCORE project group. Estimation of ten year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987-1003.</p><p>CAST (Chinese Acute Stroke Trial) Collaborative Group. CAST: randomized placebo-controlled trial of early aspirin use in 20,000 patients with acute ischemic stroke. Lancet 1997; 349: 1641-9.</p><p>IST (International Stroke Trial) Collaborative Group. The International Stroke Trial (IST): a randomized trial of aspirin, subcutaneous heparin, both, or neither among 19,435 patients with acute ischemic stroke. Lancet 1997; 349: 1569-81.</p><p>Chen Z.M., Sandercock P., Pan H.C. et al. Indication for early aspirin use in acute ischemic stroke. A combined analysis of 40 000 randomized patients from the Chines Acute Stroke Trial and the International Stroke Trial. Stroke 2000; 31: 1240-9.</p><p>Sacco R.L., Adams R., Albers G. et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack. Stroke 2006; 37: 577-617.</p><p>The European Stroke Organization (ESO) Executive Committee and the ESO Writing Committee: Guidelines for management of ischaemic stroke and transient ischaemic attacks 2008. Cerebrovasc Dis 2008; 25: 457-507.</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 TIA. Stroke 2008; 39: 1647-52.</p><p>Bhatt D.L., Scheiman J., Abraham N.S. et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Circulation 2008; 118: 1894-909.</p><p>Shireman T.I., Howard P.A., Kresowik T.F., Ellebeck E.F. Combined anticoagulant- antiplatelet use and major bleeding events in elderly atrial fibrillation patients. Stroke 2004; 35: 2362-7.</p><p>Hallas J., Dall M., Andries A. et al. Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: population-based case-control study. Br Med J 2006; 333: 726-8.</p><p>Toyoda K., Yasaka M., Iwade K. et al. Dual antithrombotic therapy increases severe bleeding events in patients with stroke and cardiovascular disease. A prospective, multicenter, observational study. Stroke 2008; 39: 1740-5.</p><p>Lip G.Y. Don't add aspirin for associated stable vascular disease in a patient with atrial fibrillation receiving anticoagulation. Br Med J 2008; 336: 614-5.</p></div><br />


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For citations:


Fonyakin A.V. Acetylsalicylic acid in the prevention and treatment of ischemic stroke. Neurology, Neuropsychiatry, Psychosomatics. 2010;2(2):71-76. (In Russ.) https://doi.org/10.14412/2074-2711-2010-89

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)