EFFECTIVENESS OF LOW-DOSE ASA IN PREVENTION OF SECONDARY ISCHEMIC STROKE, THE ASA STUDY-GROUP IN TAIWAN

This randomized double-blind controlled study was carried out to inves tigate the effect of 100 mg acetylsalicylic acid(ASA) per day on the s econdary prevention of ischemic stroke. Patients who suffered a first ischemic stroke from 13 participating hospitals were enrolled. They we re independent or only partially dependent in activities of daily livi ng and all had received brain CT for diagnosis. Eligible patients were randomly allocated to the 100 mg ASA or the nicametate citrate(a vaso dilator) groups, and trial medications were started within three to si x weeks after the onset of stroke. The primary end point was cerebral reinfarction, and intracranial hemorrhage was classified as an adverse event. Four hundred and sixty-six patients participated in this study ; and 222 cases (136 males and 86 females) were allocated to the ASA g roup while 244 cases (150 males and 94 females) were assigned to the n icametate group. No significant difference in baseline characteristics between the two groups was observed. Cerebral reinfarction developed 6.3% (14/222) in the ASA group and 11.9% (29/244) in the nicametate gr oup. According to the Cox's proportional hazards model, the estimated risk ratio (ASA group vs. nicametate group) was 0.538, with a 95% conf idence interval of 0.284-1.019. The result was of borderline statistic al significance. The risk for cerebral reinfarction was reduced by alm ost 50% among those who took 100 mg ASA versus those who took nicameta te. (C) 1997 Elsevier Science Ltd.