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Published on: February 28, 2012

Effect of aspirin and warfarin therapy in stroke patients with valvular strands

Shunichi Homma1, Marco R Di Tullio, Robert R Sciacca

  • 1Department of Medicine, Columbia University, College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA. sh23@columbia.edu

Stroke
|April 10, 2004
PubMed

Insights

Valvular strands in ischemic stroke patients do not increase adverse event rates on medical therapy. Warfarin and aspirin showed no significant difference in preventing recurrent events in this population.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Valvular strands are linked to ischemic stroke.
  • Recurrent event rates and antithrombotic therapy efficacy in stroke patients with valvular strands lack definition and randomized studies.

Purpose of the Study:

  • To define the recurrent rate of adverse events in stroke patients with valvular strands.
  • To evaluate the efficacy of antithrombotic therapies (warfarin vs. aspirin) in these patients through a randomized trial.

Main Methods:

  • The study analyzed 630 stroke patients from the Patent Foramen Ovale in Cryptogenic Stroke Study (PICSS).
  • Patients were randomized to warfarin (312) or aspirin (318).
  • Endpoints included recurrent ischemic stroke or death; all analyses were blinded and centrally adjudicated.

Main Results:

  • Valvular strands were present in 39.4% of analyzed patients (244/619).
  • No significant difference in primary endpoints was observed between patients with and without strands (P=0.82).
  • Among patients with strands, warfarin and aspirin showed no significant difference in preventing primary endpoints (P=0.21).

Conclusions:

  • Valvular strands do not significantly increase recurrent adverse event rates in ischemic stroke patients on medical therapy.
  • The study found no evidence supporting an advantage of warfarin or aspirin over the other for this patient group.
Abstract

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