Taken in large doses, aspirin can be as effective as warfarin in preventing certain types of strokes, according to a recent study published in the New England Journal of Medicine. Researchers at Emory University made the finding after conducting a study on 569 patients with blockages in their brain arteries. Aspirin has won out as the preferred treatment. ABC News reports:
“[A]spirin should [now] be used in preference to warfarin for people with intracranial arterial stenosis,” concludes the study, published in the March 31 issue of the New England Journal of Medicine.
“This should have a major impact on clinical practice,” said lead researcher Dr. Marc I. Chimowitz, professor of neurology at Emory University. “We surveyed the doctors in the study and they said aspirin should be adopted as the therapy.”
The study enrolled 569 people diagnosed with brain artery blockage after they had either full-blown strokes or short-lived “transient ischemic attacks,” or mini-strokes. Half of the patients were put on warafarin; the other half took 1,300 milligrams per day of aspirin.
The 1,300 milligram dosage — much larger than the 81 to 325 milligrams a day prescribed to prevent heart attack and stroke in otherwise healthy patients — was used because it “is the only dosage that we have evidence is as good as warfarin for this condition,” Chimowitz explained.
After an average follow-up of 1.8 years, the incidence of major problems tracked in the study — a stroke caused by a blocked artery, brain hemorrhage or death from a blood vessel-related cause — was virtually the same in both groups: 22.1 percent for those taking aspirin vs. 21.8 percent for those taking warfarin.
The trial was cut short, however, because the incidence of major problems such as heart attack or sudden death was much higher for those taking warfarin. For example, while just under 3 percent of participants taking aspirin experienced heart attack or sudden death within the nearly two years of follow-up, 7.3 percent of patients taking warfarin experienced this type of serious cardiac event.
Some controversy may linger as to the amount of aspirin to be prescribed for people with the condition, because the amount used in the study was so much larger than that used for other preventive purposes, Chimowitz said. However, he noted that the incidence of hemorrhage — the major adverse side effect associated with large doses of aspirin — was not dangerously high.
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