PERFECT - Stroke : Hoitoketjujen toimivuus, vaikuttavuus ja kustannukset aivoverenkiertohäiriöpotilailla

Verkkoversion ISBN 978-951-33-2004-1, ISSN 1795-8105PERFECT = Performance, Effectiveness and Cost of Treatment episodes -hank

Serum homocysteine, folate and risk of stroke: Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study

http://deepblue.lib.umich.edu/bitstream/2027.42/51490/1/Virtanen JK, Serum Homocysteine, Folate and Risk of Stroke, 2005.pd

Antiplatelet Therapy is Effective in Primary Prevention of Myocardial Infarction in Patients with a Previous Cerebrovascular Ischemic Event

A secondary subgroup analysis of the European Stroke Prevention Study of the effect of antiplatelet medication on the risk of myocardial infarction. —A randomized, double-blind, placebo-controlled study with two parallel treatment groups (dipyridamole plus aspirin and placebo). Sixteen centers from six countries participated in the study. —A total of 2500 patients who had had one or more transient ischemic attacks or cerebral infarctions participated. —Combination therapy with dipyridamole (75 mg three times a day) and aspirin (330 mg three times a day) was compared with placebo during 24 months' follow-up. —Prevention of fatal and nonfatal myocardial infarction. —A total of 105 myocardial infarctions occurred in the intention-to-treat analysis and 76 occurred in the explanatory analysis. The overall risk reduction of myocardial infarction with the study drugs was approximately 40% in both statistical analyses, but the result was statistically significant only in the intention-to-treat analysis. Therapeutic efficacy was better among male patients, patients younger than 65 years, and patients with hypertension. —Combination therapy with dipyridamole and aspirin reduces not only the risk of cerebrovascular ischemic events but also the risk of myocardial infarction. © 1993 Arch Neurol. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The European stroke prevention study (ESPS): Results by arterial distribution

The European Stroke Prevention Study was a multicenter study comparing the effect of the combination of dipyridamole, 75 mg, and acetylsalicylic acid, 330 mg, three times a day, to that of placebo in 2,500 patients in the secondary prevention of stroke or death after one or more transient ischemic attacks, reversible ischemic neurological deficits, or strokes of antherothrombotic origin. The patients with vertebrobasilar events at entry comprised one‐third of the whole patient population. The overall total incidene of stroke or death (the end points) during the 2‐year follow‐up in the placebo group was lower in the vertebrobasilar group compared to the carotid group (14% versus 24%, respectively). The combination therapy of dipyridamole and acetylsalicylic acid caused a marked reduction in the incidence of stroke or death in patients with vertebrobasilar (51%) and carotid (30%) events. When only stroke was considered as the end point, dipyridamole and acetylsalicylic acid seemed to be more effective in reducing the risk of transient ischemic attacks than stroke, and more effective in men than in women. Copyright © 1991 American Neurological AssociationSCOPUS: ar.jFLWNAinfo:eu-repo/semantics/publishe

European stroke prevention study: Effectiveness of antiplatelet therapy in diabetic patients in secondary prevention of stroke

Background and Purpose: The European Stroke Prevention Study was a multicenter trial comparing the effect of a combination of 75 mg dipyridamole and 330 mg acetylsalicylic acid three times a day with the effect of a placebo in the prevention of stroke or death in 1,861 patients after one or more episodes of recent transient ischemic attack or cerebral infarction. Methods: The present study represents a secondary analysis of the efficacy of study medication in diabetic (n=216) and nondiabetic (n=1,645) patients. Results: The risk of end point events was greater in diabetic than in nondiabetic subjects. Total end point reduction in individuals receiving the combination of dipyridamole and acetylsalicylic acid was 39% in nondiabetic subjects and 23% in diabetic subjects in the explanatory analysis, and the reduction in the risk of stroke was 48% and 32%, respectively. However, a statistically significant reduction of risk was obtained only in nondiabetic subjects. Conclusions: The combination of dipyridamole and acetylsalicylic acid appeared to be more effective in nondiabetic subjects than in diabetic subjects in the prevention of death and stroke although the low number of diabetic patients may at least in part explain this result.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

European stroke prevention study (ESPS): antithrombotic therapy is also effective in the elderly

The ESPS was a multicenter study comparing the effect of the combination of dipyridamole 75 mg and acetylsalicylic acid 330 mg t.i.d. to placebo in 2500 patients (intention‐to‐treat analysis) and 1861 patients (explanatory analysis) in the secondary prevention of stroke or death after one or more attacks of TIA, RIND or stroke of atherothrombotic origin. End‐point reduction was evaluated in two age groups, those not older than 65 years (1358 patients) and those who were older than 65 years (1142 patients). End‐point reduction was significantly greater in patients with active therapy than in the placebo group in both age groups. Subgroup analyses with stroke as an end‐point indicated that younger patients with TIA (≪ 65 years) had lower risk of stroke than those >65 years or patients with stroke. The overall risk reduction was best in TIA patients >65 years of age. The risk reduction with study medication was 40–50% in both sexes and in both age groups. Thus, age of the patient does not influence the efficacy of antithrombotic therapy. However, since these results are obtained from a secondary analysis of a subgroup of patients, the results may need confirmation by further studies. Copyright © 1993, Wiley Blackwell. All rights reservedSCOPUS: ar.jFLWNAinfo:eu-repo/semantics/publishe