Magazine article FDA Consumer

Study: Aspirin and Warfarin Equally Effective for Stroke Prevention. (Research Notebook)

Magazine article FDA Consumer

Study: Aspirin and Warfarin Equally Effective for Stroke Prevention. (Research Notebook)

Article excerpt

Stroke is the third leading cause of death in the United States and the leading cause of serious, long-term disability. About 600,000 new strokes are reported in the United States annually and about 160,000 Americans die each year from stroke.

A study appearing in the Nov. 15, 2001, issue of The New England Journal of Medicine indicates that aspirin works as well as warfarin in helping to prevent recurrent strokes in most patients.

The study, called Warfarin versus Aspirin Recurrent Stroke Study (WARSS) was a seven-year double-blind, randomized clinical trial involving 2,206 patients at 48 participating centers--the largest trial to date comparing aspirin to warfarin for recurrent stroke prevention. It was sponsored by the National Institute of Neurological Disorders and Stroke (NINDS).

"Treatment is far superior to no treatment and treatment with either aspirin or warfarin is safe under carefully monitored conditions," says J. P. Mohr, M.D., director of the stroke unit at Columbia University's College of Physicians and Surgeons and lead investigator of the trial.

Both drugs slow clotting of the blood, and blood clots are involved in the final stages of the most common type of stroke due to blockage of the vessels that supply oxygen-rich blood to the brain. Aspirin affects the blood platelets, while warfarin inhibits circulating clotting proteins in the blood.

Aspirin has been used for over 100 years, but its beneficial effects to prevent stroke and heart attack only started to be recognized in the 1970s. Whether warfarin was superior to aspirin for stroke prevention was unclear prior to WARSS. Numerous previous studies have proven that use of aspirin reduces recurrent stroke by about 25 percent.

Part of the controversy about aspirin versus warfarin for stroke prevention has been the thinking among physicians. …

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