PMID: 8584072Dec 1, 1995Paper

Aspirin dosage for prevention of cerebral infarct: arguments for low dosage

Der Nervenarzt
M G Hennerici, S Meairs

Abstract

Acetylsalicylic acid (ASS) is one of the best examined substances used in secondary prevention after TIA and stroke. Since different strategies and measurement variables were used in numerous randomised, double-blind, placebo-controlled studies (one end-variable, such as non-fatal stroke, myocardium infarction and vascular mortality, or combined end-variables, such as TIA, stroke and death), meta-analysis was necessary to prove that ASS resulted in about 22% reduction of secondary stroke. There is disagreement over the optimal dosage to prevent a stroke: earlier studies considered > or = 975 mg ASS per day, sometimes in combination with other substances, while more recently, lower dosages of about 300 mg per day or even as low as < or = 100 mg per day have been proposed. Higher and lower dosages were effective compared with placebo but with no significant difference in risk reduction, despite the trend towards a transient but insignificant reduction of secondary events for the high dosage. All available studies demonstrated a strictly dose-related gastro-intestinal hemorrhagic bleeding complication rate. Since no data are available from a direct comparison in a large sample size trial to prove the superiority of low-dose ASS (<...Continue Reading

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