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March 1, 1987Stroke

High-dose acetylsalicylic acid after cerebral infarction. A Swedish Cooperative Study.

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Why the study?

Does acetylsalicylic acid 1.5 g/day reduce recurrent stroke or death in patients with recent cerebral infarction?

Population

505 patients with cerebral infarction, minor or major stroke, enrolled within 3 weeks of the event

Comparison

Acetylsalicylic acid 1.5 g/day vs Placebo

Design

RCT, Randomly assigned, Double-blind

Follow-up

2 years

Discussion

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Implication

High-dose ASA should not be used for secondary prevention after cerebral infarction; challenges assumptions of benefit and guides research to alternatives.

Key Points

  • To evaluate the efficacy of high-dose acetylsalicylic acid in preventing recurrent stroke and death after cerebral infarction.
  • 505 patients with cerebral infarction were randomly assigned to receive ASA 1.5 g/day or placebo in a double-blind trial.
  • Patients were followed for 2 years to assess primary and secondary event rates.
  • Primary events included recurrent stroke or death, and secondary events included myocardial infarction and transient ischemic attack.
  • Stroke recurrence rates were similar in the ASA (12%) and placebo groups (13%).
  • First event rates for recurrent stroke or death were also not significantly different between the groups (23% for ASA vs 22% for placebo).
  • The ASA group showed no reduction in the risk of transient ischemic attack or myocardial infarction.

Structured PICO

Does acetylsalicylic acid 1.5 g/day reduce recurrent stroke or death in patients with recent cerebral infarction?

P
Population
505 patients with cerebral infarction, minor or major stroke, enrolled within 3 weeks of the event
I
Intervention
Acetylsalicylic acid 1.5 g/day
C
Comparator
Placebo
O
Outcome
Composite of recurrent stroke or deathcomposite

High-dose acetylsalicylic acid (1.5 g/day) showed no prophylactic effect against recurrent stroke or death when initiated within 3 weeks after a cerebral infarction.

Cite This Study

A 1987 study studied this question.

synapsesocial.com/papers/6a10f64539dd87f6d0eea29ahttps://doi.org/10.1161/01.str.18.2.325
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Randomized Controlled Trial of Acetyl Salicyclic Acid in the Secondary Prevention of Mortality from Myocardial Infarction1974 · 519 citations
  2. 2Controlled trial of aspirin in cerebral ischemia.1977 · 632 citations
  3. 3Aspirin as an Antithrombotic Medication1983 · 81 citations
  4. 4"AICLA" controlled trial of aspirin and dipyridamole in the secondary prevention of athero-thrombotic cerebral ischemia.1983 · 612 citations
  5. 5Differences in the Occurrence of Carotid Transient Ischemic Attacks Associated With Antiplatelet Aggregation Therapy1973 · 53 citations