Simple Stroke Prevention is Best

Aspirin appears to be a better treatment than the antiplatelet drug ticlopidine for preventing recurrent strokes in black patients, according to new research in this week’s issue of the Journal of the American Medical Association. The study included 1,809 black men and women who recently had strokes that were not due to bleeding in the brain or to blockage of a blood vessel in the brain. Participants received either a daily 500-milligram dose of ticlopidine or a daily 650-milligram dose of aspirin.
Researchers hypothesized ticlopidine would be more effective in black ischemic stroke patients than aspirin. The study was halted after 6.5 years when researchers found the exact opposite. In fact, study results suggest a 40-percent to 50-percent likelihood of aspirin being significantly better in reducing stroke risk if the study were to continue to completion. Investigators conclude, "Aspirin is much less expensive than other major antiplatelet agents, is readily available, easy to use, and relatively safe."

Blacks are about twice as likely as most other individuals in the United States to die from or experience stroke. In an accompanying editorial, Ralph Sacco, M.S., M.D., from New York Presbyterian Hospital, says, "The study provides new data on an alternate antiplatelet agent (ticlopidine) that should no longer be recommended for prevention of recurrent stroke -- certainly not in black patients."