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The author reviews the meta-analyses of recent large studies of the primary prevention of stroke with antithrombotic drugs. It is stated that acetylsalicylic acid and clopidogrel are antithrombotic agents of proven clinical efficacy in patients with stroke risk factors (coronary heart disease, clinical signs of lower extremity vascular atherosclerosis obliterans, etc.) that have no potential source of cerebral arterial embolization.

About the Author

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


1. <div><p>The Steering Committee of Physician's Health Study Research Group. Findings from the aspirin component of the ongoing Physician's Health Study. N Engl J Med 1988;318:262-4.</p><p>Eidelman R.S., Hebert P.R., Weisman S.M. et al. An Update of Aspirin in Primary Prevention of Cardiovascular Disease. Arch Intern Med 2003;163:2006-10.</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>Berger J.S., 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>Mayo Asymptomatic Carotid Endarterectomy Study Group. Results of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis. Mayo Clin Proc 1992;67:513-8.</p><p>Primary Prevention of Ischemic Stroke. A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2006;113:e873-e923.</p><p>Hirsch A.T., Haskal Z.J., Hertzer N.R. et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic). Circulation 2006;113:e463-e654.</p><p>Steg G., Bhatt D.L., Wilson P.W.F. et al. REACH Registry Investigators One-Year Cardiovascular Event Rates in Outpatients With Atherothrombosis. JAMA 2007;297:1197-206.</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>Juul-Mцller S., Edvardsson N., Jahnmatz B. et al. Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 1992;340:1421-5.</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>Patrono C., Baigent C., Hirsh J. et al. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:199-233.</p><p>Guidelines on the management of stable angina pectoris full text. The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Доступно на .</p><p>Norgren L., Hiatt W.R., Dormandy J.A. et al. TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg 2007; 33 (Suppl. 1):1-75. 15.</p><p>National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-221.</p><p>Belch J., MacCuish A., Campbell I. et al. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008;337:a1840.</p><p>Доступно на .</p><p>CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996;348:1329-39.</p><p>Bhatt D.L., Hirsch A.T., Ringleb P.A. et al., on behalf of the CAPRIE investigators Reduction in the need for hospitalization for recurrent ischemic events and bleeding with clopidogrel instead of aspirin. Am Heart J 2000;140:67-73.</p><p>Bhatt D.L., Fox K.A.A., Hacke W. et al. CHARISMA Investigators. Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Atherothrombotic Events. N Engl J Med 2006;354:1706-17.</p><p>Wang T.H., Bhatt D.L., Fox Keith A.A. et al. CHARISMA Investigators. An analysis of mortality rates with dual-antiplatelet therapy in the primary prevention population of the CHARISMA trial. Eur Heart J: doi:10.1093/eurheartj/ehm274.</p><p>Yusuf S., Zhao F. , Mehta S.R. et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001;345:494-502.</p><p>Sabatine M.S., Cannon C.P., Gibson M. et al. CLARITY-TIMI 28 Investigators. Addition of Clopidogrel to Aspirin and Fibrinolytic Therapy for Myocardial Infarction with ST-Segment Elevation. N Engl J Med 2005;352:1179-89.</p><p>COMMIT (Clоpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group. Addition of clopidogrel to aspirin in 45 852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005;366:1607-21.</p><p>Steinhubl S.R., Berger P.B., Mann III J.T. et al. CREDO Investigators. Early and Sustained Dual Oral Antiplatelet Therapy Following Percutaneous Coronary Intervention. A. Randomized Controlled Trial. JAMA 2002;288:2411-20.</p><p>The Medical Research Council's General Practice Research Framework. Thrombosis prevention trial: randomised trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk. Lancet 1998;351:233-41.</p><p>Anand S.S., Yusuf S. Oral Anticoagulant Therapy in Patients With Coronary artery Disease: A Meta-Analysis. JAMA 1999;282:2058-67.</p><p>Andreotti F. , Testa L., Biondi-Zoccai G.G.L. et. al. 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></div><br />


For citations:

Yavelov I.S. ANTITHROMBIC THERAPY IN THE PRIMARY PREVENTION OF STROKE. Neurology, Neuropsychiatry, Psychosomatics. 2009;1(1):30-34. (In Russ.)

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