Dipyridamole plus aspirin versus aspirin alone in the secondary prevention after TIA or stroke: a meta-analysis by risk

Objectives: Our aim was to study the effect of combination therapy with aspirin and dipyridamole (A+D) over aspirin alone (ASA) in secondary prevention after transient ischemic attack or minor stroke of presumed arterial origin and to perform subgroup analyses to identify patients that might benefit most from secondary prevention with A+D. Data sources: The previously published meta-analysis of individual patient data was updated with data from ESPRIT (N=2,739); trials without data on the comparison of A+D versus ASA were excluded. Review methods: A meta-analysis was performed using Cox regression, including several subgroup analyses and following baseline risk stratification. Results: A total of 7,612 patients (5 trials) were included in the analyses, 3,800 allocated to A+D and 3,812 to ASA alone. The trial-adjusted hazard ratio for the composite event of vascular death, non-fatal myocardial infarction and non-fatal stroke was 0.82 (95% confidence interval 0.72-0.92). Hazard ratios did not differ in subgroup analyses based on age, sex, qualifying event, hypertension, diabetes, previous stroke, ischemic heart disease, aspirin dose, type of vessel disease and dipyridamole formulation, nor across baseline risk strata as assessed with two different risk scores. A+D were also more effective than ASA alone in preventing recurrent stroke, HR 0.78 (95% CI 0.68 – 0.90). Conclusion: The combination of aspirin and dipyridamole is more effective than aspirin alone in patients with TIA or ischemic stroke of presumed arterial origin in the secondary prevention of stroke and other vascular events. This superiority was found in all subgroups and was independent of baseline risk. ---------------------------7dc3521430776 Content-Disposition: form-data; name="c14_creators_1_name_family" Halke

Discovery of an unidentified Fermi object as a black widow-like millisecond pulsar

The Fermi Gamma-ray Space Telescope has revolutionized our knowledge of the gamma-ray pulsar population, leading to the discovery of almost 100 gamma-ray pulsars and dozens of gamma-ray millisecond pulsars (MSPs). Although the outer-gap model predicts different sites of emission for the radio and gamma-ray pulsars, until now all of the known gamma-ray MSPs have been visible in the radio. Here we report the discovery of a "radio-quiet" gamma-ray emitting MSP candidate by using Fermi, Chandra, Swift, and optical observations. The X-ray and gamma-ray properties of the source are consistent with known gamma-ray pulsars. We also found a 4.63-hr orbital period in optical and X-ray data. We suggest that the source is a black widow-like MSP with a ~0.1 solar-mass late-type companion star. Based on the profile of the optical and X-ray light-curves, the companion star is believed to be heated by the pulsar while the X-ray emissions originate from pulsar magnetosphere and/or from intra-binary shock. No radio detection of the source has been reported yet and although no gamma-ray/radio pulsation has been found, we estimated that the spin period of the MSP is ~3-5 ms based on the inferred gamma-ray luminosity.Comment: 6 pages, 2 figures; accepted for publication in ApJ

MITSuME--Multicolor Imaging Telescopes for Survey and Monstrous Explosions

Development of MITSuME is reported. Two 50-cm optical telescopes have been built at Akeno in Yamanashi prefecture and at Okayama Astrophysical Observatory (OAO) in Okayama prefecture. Three CCD cameras for simultaneous g'RcIc photometry are to be mounted on each focal plane, covering a wide FOV of about 30" x 30". The limiting magnitude at V is fainter than 18. In addition to these two optical telescopes, a 91-cm IR telescope with a 1 deg x 1 deg field of view is being built at OAO, which performs photometry in YJHK bands. These robotic telescopes can start the observation of counterparts of a GRB within a minute from an alert. We aim to obtain photometric redshifts exceeding 10 with these telescopes. The performance and the current construction status of the telescopes are presented.Comment: 4 pages, 3 figures, 4th Workshop on Gamma-Ray Burst in the Afterglow Era, Roma, October 18-22, 200