Anticoagulant vs anti-platelet therapy as prophylactic against cerebral infarction in transient ischemic attacks

Completed

Phase N/A Results

Trial Description

To compare anticoagulant (AC) treatment with anti-platelet treatment in the prevention of cerebral infarction in patients with transient ischemic attacks or reversible ischemic deficit.

Interventions

  • Aspirin (stroke prevention) Drug
    Intervention Desc: Antiplatelet agent; inhibits thromboxane A2
  • Dipyridamole (Persantine┬«)Drug
    Intervention Desc: Platelet aggregation inhibitor
  • Warfarin (Coumadin┬«)Drug
    Other Names: Coumadin; Acenocoumarol
    Intervention Desc: Anticoagulant (Vitamin K antagonist)

Trial Design

Prospective, randomized trial of 156 patients at 5 centers.

Patient Involvement

All patients were given AC treatment with coumadin for 2 months in addition to heparin infusion (20-40000 IU/day based on maintaining arterial thromboplastin time <= 100s) during the first 4-5 days of treatment. After 2 months, the remaining patients were randomized to continue with AC treatment or to switch to anti-platelet therapy for 12 months. The AC treatment was controlled with the TT-test to a therapeutic range between 7-15% of normal. The anti-platelet therapy consisted of acetylsalicylic acid (0.5 g x 2) plus dipyridamole (75 mg x 2). Patients with new cerebral symptoms and blood-salicylate < 0.1 mmol/l were given higher doses of acetylsalicylic acid and dipyridamole.

Outcomes

Type Measure Time Frame Safety Issue
No outcomes associated with this trial.

Sponsors

Swedish National Association against Heart and Chest Diseases and Greta and Johan Koch's Foundation