Antiplatelet Agents In Stroke Prevention Research Articles

Stroke prophylaxis: hypertension management and antithrombotic therapy.

To review trials involving risk factor management and pharmacologic therapy for the prevention of stroke. English-language literature published between 1966 and 1992 was analyzed; pertinent literature is reviewed. Studies that evaluated the impact of risk factor management on prevention of vascular events were selected. In addition, trials assessing the safety and efficacy of pharmacologic intervention in primary and secondary stroke prevention were evaluated. Trials were evaluated for their ability to demonstrate a decrease in stroke occurrence. Various trials were analyzed in several categories. Studies evaluating risk factor management of hypertension and cardiogenic cerebral emboli were reviewed and recommendations made based on a consensus of these trials. The use of antiplatelet agents in stroke prevention was addressed by a review of pertinent trials and meta-analyses. The control of risk factors and the use of antiplatelet agents significantly reduces the risk of vascular events. Benefit from different therapies may be specific to certain patient populations and recommendations are made for these patients.

Physicians' attitudes toward oral anticoagulants and antiplatelet agents for stroke prevention in elderly patients with atrial fibrillation

Physicians' attitudes toward oral anticoagulants and antiplatelet agents for stroke prevention in elderly patients with atrial fibrillation

Physicians' Attitudes Toward Oral Anticoagulants and Antiplatelet Agents for Stroke Prevention in Elderly Patients With Atrial Fibrillation

The use of oral anticoagulants and antiplatelet agents for the prevention of strokes in elderly patients with atrial fibrillation is controversial. Recent studies suggest that warfarin and aspirin can be safe and effective in selected patients. To determine attitudes toward this subject, we sent a questionnaire to 480 attending physicians at two major university-affiliated medical centers. Among the 251 responses (52.3%), 46 respondents (18.3%) used warfarin in atrial fibrillation of any cause, 175 (69.7%) used it in atrial fibrillation with transient ischemic attacks, 161 (64.1%) used it in patients with cerebrovascular accidents, and 196 (78.0%) used it in patients with mitral valve disease. One hundred twenty-nine (51.4%) believed that the risk of hemorrhage associated with warfarin outweighs the benefit, 61 (24.3%) were not convinced that warfarin prevents strokes in atrial fibrillation, and 42 (16.7%) believed it was difficult to monitor prothrombin time in the elderly because of poor compliance. Aspirin was used by 91 physicians (36.2%) in atrial fibrillation of any cause, 161 (64.1%) in patients with transient ischemic attacks, 140 (55.7%) in patients with cerebrovascular accidents, and 48 (19.1%) when patients were in sinus rhythm. We concluded that physicians are still hesitant to use oral anticoagulants and antiplatelet agents for the prevention of strokes in their elderly patients with atrial fibrillation. These agents are used most frequently after an ischemic episode (transient ischemic attack or cerebrovascular accident) has occurred or in patients with mitral valve disease.

Antiplatelet agents in stroke prevention.

Antiplatelet agents in stroke prevention.