REVIEW – July 2003

Aspirin and secondary prevention of ischemic stroke


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Incidence of stroke is high or increasing in many countries. No effective treatment has been found except for thrombolysis which decreases the disability after stroke. Thrombolytic therapy in the acute stage of stroke is limited due to its contraindications. The most effective method reducing the burden of stroke on the society is primary and secondary prevention. Ischemic stroke accounts for 80% of all stroke cases. Atherosclerosis of the arteries, supplying the brain is the most common cause of ischemic stroke. Pathogenesis of brain infarction is related to activation of platelets, formation of aggregants and thrombosis of the vessel.
Aspirin is the most widely used antiaggregative agent in the primary prevention of atherosclerotic diseases.
Data based on clinical trials on the use of aspirin in primary and secondary prevention of ischemic stroke are given. It was found that treatment with aspirin is the most effective method for secondary prevention of ischemic stroke. The treatment should be started in the acute stage of brain infarction or after the first TIA.
Aspirin is also effective in the patients with atrial fibrillation if treatment with anticoagulants is contraindicated.